Health care organizations and governments around the world continue to work to contain the coronavirus pandemic. Health care professionals are preparing for a widespread outbreak, taking measures to address the potential increase in patient volumes that may put a significant strain on medical equipment supplies and hospital care units. Through this preparatory phase, telemedicine is being considered and implemented as a way to engage with patients who are potentially infected, as well as those who need to stay home and avoid exposure.
The great news is that both state and federal regulations and laws have progressed over the past few months and years to make it easier to adopt and use telemedicine services. More recently, measures have been passed by Congress to make it easier for medical professionals to use telemedicine in response to the current COVID-19 outbreak. However, if your practice is considering the implementation of new telemedicine systems, there are many regulatory and legal issues you must consider as you plan and implement this technology.
Implementing Telemedicine to Combat COVID-19
Telemedicine offers the ability to address some needs that are unique to the recent COVID-19 outbreak. Public health agencies, the Centers for Disease Control, and others have endorsed the use of telemedicine by hospitals and practices as a response to the coronavirus. Over the past week, the situation has progressed and more people than ever are under a home quarantine. U.S. public health officials, insurance companies, and medical professionals are now pushing patients to use telemedicine to address minor problems from home so they can skip the clinic or doctor’s office. It also offers a way to check in with a physician when patients believe they’re displaying the symptoms of COVID-19.
With the current novel disease surgery, it’s common for large numbers of worried patients and symptomatic patients who may not otherwise be exposed to seek care from a physician for guidance and reassurance. Unfortunately, this increases the risk of exposure to infectious disease and also results in the overcrowding of emergency rooms, urgent care clinics, and primary care offices. By implementing telemedicine systems, it addresses the needs of these patients directly to prevent additional exposure and the overcrowding of medical practices and facilities.
The Telemedicine Regulatory and Legal Landscape Continues to Evolve
Within the past few years and months, the regulatory and legal landscape surrounding telemedicine rapidly evolved. Regulations and laws at state and federal levels have been expanded significantly, allowing for greater utilization of these platforms. Some of the changes include a relaxation in technology requirements, relaxation of supervision laws in regard to non-physician providers, and improvements in reimbursements for these services. Both Medicaid and Medicare have expanded their telemedicine reimbursement so a broader variety of patient care situations and services are covered.
In light of the current COVID-19 outbreak, Congress just made some changes to relax some of the requirements surrounding telemedicine in the Coronavirus Preparedness and Response Supplemental Appropriations Act. This legislations allows health care professionals to bill fee-for-service for any patient care delivered via telehealth during this public health emergency. It also gave the U.S. Department of Health and Human Services secretary the ability to modify or waive various telehealth Medicare requirements when a Public Health Emergency has been declared by the HHS secretary (which was done on Jan 31, 2020) or the President declares a National Emergency.
For example, the HHS secretary can waive originating site requirements during emergency periods. Telehealth services may also be provided by phone as long as the phone allows for both audio and video interaction between the patient and qualified provider. CMS also recently clarified that the established-relationship rule won’t be enforced right now, but the patient has to initiate the telehealth service and provide consent for virtual treatment. This consent needs to be documented within their medical record for the telehealth services are provided.
However, while some requirements are being relaxed, health care professional still need to comply with state telehealth regulations and laws. This includes scope of practice, professional licensure, patient consent, standard of care, and additional requirements for private payers.
When billing for these telehealth services, you’ll typically use E/M codes with a telehealth Place of Service code (02), and if working with a commercial payer, possibly a modifier. Keep in mind, certain communications-based technology codes are not considered to be telehealth services, which means they aren’t subject to many of the restrictions that surround other telehealth services.
Key Regulatory and Legal Diligence Considerations as You Respond to COVID-19
As your practice is determining how to begin implementing telemedicine in response to COVID-19, a variety of regulatory and legal diligence considerations must be considered, including:
- Ensuring compliance with state-based technology requirements and standards in the state where the patient receives care.
- Consider the options for reimbursement and put systems in place to ensure your practice is reimbursed.
- Ensure you’re complying with state supervision and delegation laws regarding non-physician providers who may be providing telemedicine services.
- Make sure that providers are licensed within the states where the patient will be treated and assessed.
- Be sure to comply with state and federal laws that prohibit providers from prescribing any control substances when using telemedicine services.
- Make sure you’re complying with other state or federal laws, such as the Labor Act and Emergency Medical Treatment.
- Evaluate your vendor contracting for telecommunications tools ensuring that they comply with federal and state data security and privacy laws.
As the medical field continues responding to the COVID-19 outbreak, telemedicine platforms offer an excellent solution to coordinating care while improving access to care and minimizing exposure. Currently, telemedicine regulations and laws have been relaxed and expanded, but you still need to consider regulatory and legal issues as you begin to implement telemedicine into your practice. Ensuring that you get paid for these services is also critical, and that’s where M-Scribe.com can help. We’re experts in telemedicine billing and can work with your practice to ensure you get paid while you do what you do best – treat patients and help them through this pandemic. To learn more about how we can help you with billing and coding, contact M-Scribe.com today.