Ferrante Explains How the Rules of Telemedicine Have Changed Amid COVID-19 Pandemic

25 March 2020 The Hospital Finance Podcast News

Senior Counsel Thomas Ferrante appeared on the The Hospital Finance Podcast, “Telehealth changes related to COVID-19” to discuss how the  rules and practice of telehealth have changed rapidly in response to the Covid-19 pandemic.

Ferrante said since the COVID-19 outbreak, everything has changed with respect to Telemedicine. “Historically, the Medicare fee for service paid for telehealth services. But it was very, very limited. You sort of needed a perfect storm of criteria to be able to receive payment. And it was often touted or pointed to say, “Look. This is one of the reasons that telehealth really hasn’t taken off as much as it could have in the industry because of the slow movement to expand the criteria for coverage by the government.” And a lot of people would blame CMS for this. But it really wasn’t completely CMS’s fault. A lot of it was because these restrictions are located in the statutes. And the statutes can’t be changed by CMS unilaterally. It requires an act of Congress. And historically, the legislature hasn’t had the appetite to really take on that type of change,” he said.

“Now, given the public health emergency that was announced earlier in March, that changed the game for a lot of those coverage requirements,” he added. “What was passed was a public health law that actually amended those requirements for a period of time, those statutory requirements. And those requirements historically were– the big ones were that a patient had to be located to receive telehealth services and receive payment. The patient had to be located in a qualifying rural area. So that basically outside of a metropolitan statistical area or in a health professional shortage area. So somewhere like Manhattan obviously wouldn’t count. It’s your typical rural communities. And the patient also had to be in a qualifying originating site. And that is typically with like a doctor’s office or a hospital or a nursing home, definitely not the patient’s home in most cases. That all went by the wayside with this new law change for the waiver. And as of right now, the patient can be located anywhere and would be eligible if it’s a Medicare beneficiary for that provider to receive telehealth payment and at the same rate as if that person had come in for an in-person visit. And the policy reason for this is to really keep patients that– out of the emergency room, out the hospital system right now that is being stressed with the COVID-19 epidemic with all the testing and the treatment for those people. And so part of the policies that try to treat remotely were at whenever possible. And this is one of the tools that CMS has used by waiving the historical law.

Listen to the full podcast here.

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