NMTHA Webinars Available on Website New Mexico Telehealth Alliance Dec. 14, 2021 Did you miss one of our webinars this year? Did you know you can access them on the NMTHA website and view them at your leisure? Topics include HIPAA compliance, expanding telemed services, billing and coding and more. Did you miss one of our webinars this year? Did you know you can access them on the NMTHA website and view them at your leisure? Topics include HIPAA compliance, expanding telemed services, billing and coding and more. < Previous News Next News >

2021 National Telemedicine Summit World Conference Forum, LLC Sept. 13, 2021 Key Strategies to Revolutionize & Transform Healthcare Delivery, Optimize Quality Patient Care & Outcomes, Increase Accessibility, Enhance Data Analytics, and Reduce Costs! September 13 – 14, 2021 • The Ritz-Carlton, South Beach • Miami, FL Today, telemedicine is one of the fastest growing sectors in healthcare. Specifically, COVID-19 has enhanced and accelerated the role that telemedicine plays within our healthcare system. It is reshaping the landscape of healthcare delivery in the United States, and is being recognized as the future of global healthcare. Telehealth addresses and achieves the basic tenants of Healthcare Reform: providing the population with access to improved and convenient, high quality patient centric care, enhancing outcomes, while reducing per capita expenditures. Today, more than 70 percent of hospitals throughout the United States are engaged in telehealth programs. Studies have shown that the benefits of telehealth include significantly improved outcomes, efficient care delivery as well as reduction in mortality rates, hospitalizations, length of stay, readmissions and healthcare costs. Telehealth has greatly enhanced access to quality care in rural areas and patient satisfaction has increased due to its convenience and patient centric approach. We have created an exciting, high level forum featuring knowledgeable leaders and executives from the nation's leading Hospitals and Health Systems who will share their perspectives, valuable insights and expertise on how to be best equipped for the rapidly evolving and exciting landscape of telehealth. This exclusive event targets senior level executives in order to maximize educational and networking opportunities. By attending the 2021 National Telemedicine Summit, you will learn what highly regarded Hospitals and Health Systems are doing to be prepared for the challenges that lie ahead in 2021 and beyond! We look forward to greeting you in Miami! Link: https://www.wcforum.com/conferences/telemedicine < Previous News Next News >

A Decade of Telehealth Policy: A New Report From CCHP Mei Kwong- Center for Connected Health Policy August 2022 Ten years ago, in the early months of 2012, the Center for Connected Health Policy (CCHP) faced a decision of potentially great significance. The U.S. Health Resources and Services Administration (HRSA) Federal Office of Rural Health Policy (FORPH) Office for the Advancement of Telehealth (OAT) had released a Funding Opportunity Announcement for their Telehealth Resource Center Grant Program and the incumbent contractor for the National Telehealth Resource Center for Policy (NTRC-P) contract would not be reapplying. After weighing the pros and cons of acting as the NTRC-P, CCHP decided to take the plunge and applied. On September 1, 2012, CCHP officially started its work as the federally designated National Telehealth Policy Resource Center and have been serving that role for the past decade. To mark CCHP’s ten-year anniversary as the NTRC-P, we are releasing a look back on telehealth policy in the United States. For the past decade, CCHP has tracked and followed policy development for all 51 jurisdictions in the United States (District of Columbia included) as well as at the federal level providing us with the unique opportunity to observe and study the development of telehealth policy in the United States on both the state and federal levels. This past decade also happens to be the period that encompasses some of the most significant telehealth policy developments seen thus far in the United States. The report is not intended to be an in-depth study on telehealth policy development and history as that could easily be an entire novel given the complexities and nuances that would need to be considered. The National Telehealth Resource Center for Policy Ten-Year Anniversary Report is intended to capture some of the highlights, significant changes, and environmental factors that have had an impact on telehealth policy development in the nation. Considering the increased interest in telehealth policy, CCHP believes this report also will be useful to provide context on how telehealth policy came to be where it is today, particularly for those who may be newer to the field. Additionally, the report is meant to be a celebration of the time CCHP has spent as the NTRC-P including the contributions the organization has made to the telehealth field. This report is dedicated to the memory of Mario Gutierrez, CCHP Executive Director from 2011-2017. Mario was the original visionary who decided in 2012 that CCHP should apply for the project. A special thank you must also be extended to CCHP staff, both past and present, who have truly been the engine that continues to drive the work of the organization forward. Special acknowledgment must be made of Laura Stanworth, Deputy Director, and Christine Calouro, Senior Policy Associate, both who have been with CCHP from the beginning of its role as the NTRC-P and who, along with myself, have seen this past decade of telehealth policy development, including producing all information and navigating CCHP through those first few months of the COVID-19 pandemic. We hope you will enjoy this report and find the information useful. CCHP looks forward to continuing on the ever evolving telehealth policy journey with all of you. See full report: https://mailchi.mp/cchpca/a-decade-of-telehealth-policy-our-10-year-anniversary-report < Previous News Next News >

CONGRESS UNVEILS TWO YEAR EXTENSION OF TELEHEALTH FLEXIBILITIES – AS URGED BY THE ATA AND ATA ACTION – AS PART OF OMNIBUS BILL The American Telemedicine Association December 20, 2022 Today, the American Telemedicine Association (ATA) and ATA Action express their gratitude to the U.S. Congress for unveiling a bipartisan, bicameral omnibus appropriations bill that includes a two-year extension for Medicare telehealth provisions put in place during the COVID-19 public health emergency (PHE). The omnibus package also includes a two-year delay in implementing the Medicare telemental health in-person requirement, a two-year extension of the safe harbor to offer telehealth in High Deductible Health Plans (HDHPs) with Health Savings Account (HSAs), and a two-year extension of the Acute Hospital Care at Home Program. Congress is expected to vote on the omnibus bill and send it to President Biden to be signed into law within the next week. The omnibus did not include a comparable extension past the end of the PHE of the Ryan Haight in-person waiver for the remote prescription of controlled substances. However, the legislation does include language directing the Drug Enforcement Administration (DEA) to promulgate final regulations specifying the circumstances in which a Special Registration for telemedicine may be issued and the procedure for obtaining the registration. “The ATA and ATA Action never wavered from our appeal to Congress, to provide stability around the life-saving telehealth flexibilities that have become a relied upon and valued option for healthcare providers and patients. Today, our Congressional telehealth champions on both sides of the aisle came through for the American people and for ATA and ATA Action members, by meeting our plea for more certainty around telehealth access for the next two years, while we continue to work with policymakers to make telehealth access a permanent part of our healthcare delivery for the future,” said Kyle Zebley, senior vice president, public policy, American Telemedicine Association, and executive director, ATA Action. “We asked Congress and they listened. We are truly grateful for their staunch support of telehealth. It’s now time to swiftly bring this bill to the President, for passage into law before year-end.” Stakeholder Letter to Congressional Leadership – Urging Extension of Telehealth Flexibilities Stakeholder Letter Urging Congress to Act on the Telehealth High Deductible Health Plan Safe Harbor Tax Provision ATA’s Recommendation’s for Acute Hospital Care at Home Program Stakeholder Letter Urging the DEA to Act on the Prescription of Controlled Substances via Telehealth Before the PHE Expires “We greatly appreciate Congress including extensions the High Deductible Health Plan (HDHP) and Health Savings Account (HSA) telehealth tax provision, giving American workers continued access to needed telehealth coverage without first having to meet annual deductibles, including telemental health services. Further, the extension to the Acute Hospital Care at Home Program ensures continued access to this patient-centered care delivery model that is proving to effectively lower cost of care while improving patient health outcomes and satisfaction. “The ATA and ATA Action are delivering on our promise, to advocate for permanent access for telehealth services and today marks a significant milestone towards that goal. But the hard work continues, as we persist in pressing telehealth permanency and creating a lasting roadblock to the ‘telehealth cliff.’ Additionally, we will continue to work with Congress and the Biden administration to make sure that a predictable and preventable public health crisis never occurs by giving needed certainty to the huge number of Americans relying on the clinically appropriate care achieved through the Ryan Haight in-person waiver.” About ATA Action ATA Action recognizes that telehealth and virtual care have the potential to transform the healthcare delivery system by improving patient outcomes, enhancing the safety and effectiveness of care, addressing health disparities, and reducing costs. ATA Action is a registered 501c6 company and an affiliated trade organization of the ATA. About the ATA As the only organization completely focused on advancing telehealth, theAmerican Telemedicine Association is committed to ensuring that everyone has access to safe, affordable, and appropriate care when and where they need it, enabling the system to do more good for more people. The ATA represents a broad and inclusive member network of leading healthcare delivery systems, academic institutions, technology solution providers and payers, as well as partner organizations and alliances, working to advance industry adoption of telehealth, promote responsible policy, advocate for government and market normalization, and provide education and resources to help integrate virtual care into emerging value-based delivery models. See original article: https://www.americantelemed.org/press-releases/congress-unveils-two-year-extension-of-telehealth-flexibilities-as-urged-by-the-ata-and-ata-action-as-part-of-omnibus-bill/ < Previous News Next News >

Telehealth Legislation Re-Introduced National Council for Behavioral Health March 12, 2021 This week, Sens. Portman (R-OH) and Whitehouse (D-RI) and Reps. McKinley (R-WV), Budd (R-NC), Cicilline (D-RI), and Trone (D-MD) re-introduced the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act. The legislation, first introduced last Congress, seeks to support the expansion of telehealth services for substance use care. The TREATS Act would allow for the prescription of medication-assisted treatment (MAT) without a prior in-person visit, and for Medicare to be billed for audio-only telehealth services. The National Council supports these efforts to expand access to needed substance use services. This week, Sens. Portman (R-OH) and Whitehouse (D-RI) and Reps. McKinley (R-WV), Budd (R-NC), Cicilline (D-RI), and Trone (D-MD) re-introduced the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act. The legislation, first introduced last Congress, seeks to support the expansion of telehealth services for substance use care. The TREATS Act would allow for the prescription of medication-assisted treatment (MAT) without a prior in-person visit, and for Medicare to be billed for audio-only telehealth services. The National Council supports these efforts to expand access to needed substance use services. < Previous News Next News >

Healthcare Breaches: 40.7 Million Patients Affected By Dr. Maheu April 5, 2021 There were 758 breaches publicly posted to the Department of Health and Human Services (HHS) breach portal in 2020, affecting 40.7 million patients. However, the breaches listed on the HHS breach portal only reflect breaches affecting 500 or more patients, making it likely that the number of breaches was much higher. Each year Protenus, along with databreaches.net, conducts a breach report to assess the state of healthcare cybersecurity. Their 2021 Breach Barometer examined healthcare breaches occurring in 2020 and compared the findings to 2019 breaches. Read more about previous healthcare breaches on TBHI blogs: Healthcare Data Breach compromised 295,617 patients, Major Healthcare Hack Targets Mental Health Provider and Healthcare Breach: Email Breach Affects Behavioral Health Organization. More details on healthcare breaches, hacking incidents, insider breaches of 2020 are discussed below. Healthcare Breaches in 2020 There were 758 breaches publicly posted to the Department of Health and Human Services (HHS) breach portal in 2020, affecting 40.7 million patients. However, the breaches listed on the HHS breach portal only reflect breaches affecting 500 or more patients, making it likely that the number of breaches was much higher. Through their analysis of 2020 breaches, Protenus determined a 30% increase in healthcare breaches compared to 2019. Hacking Incidents in 2020 The leading cause of 2020 healthcare breaches resulted from hacking incidents representing 62% of reported incidents, with a 42% increase in these types of incidents from the previous year. The 277 hacking incidents compromised the protected health information (PHI) of more than 31 million patients. Part of the reason hacking skyrocketed in the healthcare sector is due to hackers exploiting the COVID pandemic, in some cases posing as government agencies to gain access to sensitive information. The issue was a major cause for concern, with the FBI and HHS warning healthcare organizations against “an increased and imminent cybercrime threat to U.S. hospitals and healthcare providers.” Researchers stated, “By making investments to protect patients, health systems, in turn, protect themselves from severe reputational damage, financial penalties, or care disruptions stemming from hacking incidents. Under obligation to do no harm, healthcare organizations must adopt advanced tools capable of preventing hacks and their frightening consequences for patients.” Insider Breaches in 2020 The second most common cause behind healthcare breaches in 2020 was insider breaches. Insider breaches occur when an employee of a healthcare organization accesses PHI without cause. Insider breaches represented 20% of reported incidents, with 111 incidents of insider breaches compromising the PHI of 8.5 million patients. “A zero-tolerance stance on snooping is important, but it will never be enough to prevent innocent mistakes or nefarious hackers,” researchers wrote. “Only by using compliance analytics to calculate the risk score of any anomalous access can organizations surface and prioritize interactions with data that truly warrant attention…. Noncompliance is critically important to identify and prevent, especially when organizations are struggling financially. Compliance incidents are costly because of all that goes into reconciling them. On top of paying penalties, health systems must do damage control,” they added. HIPAA Resources Need assistance with HIPAA compliance? Compliancy Group can help! They help you achieve HIPAA compliance, with Compliance Coaches® guiding you through the entire process. Find out more about the HIPAA Seal of Compliance® and Compliancy Group. Get HIPAA compliant today! Link: https://telehealth.org/healthcare-breaches-2/?utm_source=ActiveCampaign&utm_medium=email&utm_content=New+COVID-19+FCC+Telehealth+Grant+%7C+TBHI+Telehealth+News+4%2F14%2F21&utm_campaign=April+13th+Newsletter&vgo_ee=L60XUD6gIFzXzaAzbkkf6r35hO7C%2FF3J%2FgQB9Uu3XAY%3D < Previous News Next News >

Amazon’s New Partnership With Teladoc Is A Huge Milestone For Telemedicine Sai Balasubramanian, M.D., J.D., Contributor March 23, 2022 Last month, global technology and e-commerce giant Amazon and telemedicine company Teladoc announced a landmark new initiative: providing virtual care through Amazon Alexa devices. The announcement indicates that “Customers in the U.S. will now be able to connect with a Teladoc care provider 24/7 from supported Echo devices for general medical needs. Teladoc on Alexa will initially launch via audio with video visits coming soon.” Donna Boyer, Chief Product Officer of Teladoc, explained further: “Teladoc Health’s collaboration with Amazon is yet another step in breaking down barriers to healthcare access […] By introducing and integrating our virtual first care experience with Echo devices, we are providing an innovative and convenient way for users to connect with a doctor. We are meeting consumers where they are, to continue to deliver value and high-quality care to members.” Indeed, this is a huge milestone for both companies. Teladoc went public in a deal worth nearly $157 million dollars in 2015, right when digital health and telehealth were becoming more prominent concepts in care delivery. However, Teladoc found its true stride during the height of the Covid-19 pandemic, when people worldwide were forced into isolation and quarantine—highlighting the value of virtual care services. Indeed, the concept has significant promise in solving many modern day healthcare problems. Congruently, Amazon has continued to make its own strides in healthcare. With the launch of Amazon Care as well as its robust pharmaceutical services, the company is slowly but surely developing an entire ecosystem which will likely soon become a mainstream modus of care delivery. Now, with this new partnership, both companies are significantly increasing their reach. With 100s of millions of Alexa devices currently in use, the potential value of this partnership is endless. It provides consumers with a convenient, easy, and creative way to get their healthcare services inside of their own homes. The process is relatively simple: “To get started, customers can say, ‘Alexa, I want to talk to a doctor,’ to their supported Echo device to get connected with the Teladoc call center. Customers will then get a call back on their Echo devices from a Teladoc doctor for virtual visits related to non-emergency health needs, such as experiencing symptoms of a cold, flu, or allergies. The cost per visit can be as low as $0 per visit with insurance or $75 without insurance.” For full article click this link: https://www.forbes.com/sites/saibala/2022/03/23/amazons-new-partnership-with-teladoc-is-a-huge-milestone-for-telemedicine/?sh=7acb8fcd7f18 < Previous News Next News >

For next steps on telehealth, look to the states By Kat Jercich January 26, 2021 Lawmakers in legislatures nationwide have introduced about 300 bills aimed at expanding access to telemedicine – but not every bill is equally helpful. As the United States approaches its one-year anniversary of the COVID-19 pandemic beginning to disrupt normal healthcare operations, a question continues to endure: What's next for telehealth? The answer remains unclear on a federal level, with U.S. lawmakers recently reintroducing legislation that would take at least a few steps toward safeguarding virtual care. In the meantime, though, state legislatures have taken action – and experts say their movement in this regard is unprecedented. "I've been doing this a long time, and I've never seen anything like this," said Claudia Tucker, senior vice president of government affairs at Teladoc, during the third installment of the American Telemedicine Association's EDGE policy conference on Tuesday. HIMSS20 Digital Learn on-demand, earn credit, find products and solutions. Get Started >> As Tucker described it, lawmakers in nearly every state have introduced about 300 bills in the last few months aimed at expanding access to telemedicine. But, she said, not every one of those bills has equal merit. Some, for instance, require providers to see a patient in-person before allowing audio-only appointments – a move that legislators may not realize will have a chilling effect on care. "State policy matters. When you put clinically unnecessary barriers to care [into place] through state policy … they can be a big deal," noted Quinn Shean, managing director at Tusk Ventures/Tusk Strategies. Shean also noted that many of the hundreds of bills being introduced engage with the "who, what, where and when" of telehealth: what types of providers can provide it, and which modality they can use. "We're seeing states catch up based on their experience in the pandemic," she said. Panelists throughout the day pointed to the double-edged sword of telehealth: It can enable patient access, but it can also deepen the digital divide. "The idea that someone living in Appalachia can have access to one of the best oncologists in the country through telehealth is life changing," said Tucker. As Evan Hoffman, director of state and local government relations, pointed out, virtual care can be instrumental in helping keep struggling rural hospitals open. Telehealth tools, he said, "can beam [provider input] in to support rural hospitals and their efforts to engage patients. The flurry of bill volume cannot be understated in telehealth." At the same time, said Shean, "It's going to be on industry and stakeholders to make sure we do use telehealth as a great equalizer." One potential make-or-break issue when it comes to equity is broadband access – whether patients are able to connect with providers at all. "We have seen, especially in our lower-income areas … the disparity in accessibility widen," said New York State Assembly member Pamela Hunter, D-Syracuse. "We need to make sure that those who need accessibility in care – the most vulnerable – are able to utilize this up-and-coming ... technological health-delivery system," continued Hunter. At this point, she said, "it really is not for everyone." Experts also pointed to coverage and reimbursement as pivotal issues for broader access after the COVID-19 pandemic. "We're going to have to talk about parity," said Minnesota Senator Michelle Benson, R-Anoka. "There is some concern that providers are going to have to be held accountable" for potentially inappropriately charging for services. "I don't know how that looks in statute," Benson admitted. "I hate it when legislators are overly prescriptive," she continued, but maintained that some regulation would undoubtedly be necessary. When it comes to policy progress over the next 100 days, Tucker advised, "follow the money." "There's a huge focus on money, reimbursement, health plans," she said. "It's all about: 'Where does the money go?'" Telehealth, she argued, begets access, quality of care, and savings. "Let's not forget that third one," she emphasized. "The flurry of bill volume cannot be understated in telehealth," noted Hoffman. "It speaks to the tremendous opportunity before us." Shean added that the industry is, for the most part, past the need to simply prove the merits of telehealth. Instead, she said, "We should be using this time of telehealth advancement to be rethinking … to really think bigger." Kat Jercich is senior editor of Healthcare IT News. Twitter: @kjercich Email: kjercich@himss.org Healthcare IT News is a HIMSS Media publication. < Previous News Next News >

Medicare Telehealth Services for 2023 – CMS Proposes Substantial Changes The National Law Review August 6, 2022 - Volume XII, Number 218 On July 7, 2022, the Centers for Medicare and Medicaid Services (CMS) released its proposed 2023 Medicare Physician Fee Schedule (PFS) rule. The rule, if enacted as proposed, will: 1. Create three new permanent telehealth codes for prolonged E/M services; 2. Discontinue reimbursement of telephone (audio-only) E/M services; 3. Discontinue the use of virtual direct supervision; 4. Postpone the effective date of the telemental health six-month rule until 151 days after the PHE ends; 5. Extend coverage of the temporary telehealth codes until 151 days after the PHE ends; and 6. Add 54 codes to the Category 3 telehealth list. Reading between the lines, the nature of CMS’ comments and the changes it proposed (and refused to propose) suggest that CMS rulemakers anticipate the Public Health Emergency (PHE), and associated PHE waivers, will expire no later than the first half of 2023. Three New Telehealth Codes for Prolonged E/M Services: This year, CMS rejected all stakeholder requests to permanently add codes to the Medicare Telehealth Services List. Following its standard evaluation process for such requests, CMS considered whether they met appropriate categories. Category 1 services must be “similar to professional consultations, office visits, and/or office psychiatry services that are currently on the Medicare Telehealth Services List.” Category 2 services require “evidence of clinical benefit if provided as telehealth” and all necessary elements of the service must be able to be performed remotely. CMS rejected this year’s requests because none of the proposed services (e.g., therapy, electronic analysis of implanted neurostimulator pulse generator/transmitter, adaptive behavior treatment and behavior identification assessment codes) met the requirements of Category 1 or 2 services. Interested stakeholders can collect and submit better evidence to persuade CMS to add these codes on a Category 1 or 2 basis next year (submissions are due by February 10, 2023). Although it rejected stakeholder-submitted codes, CMS itself proposed three new codes to be added to the Medicare Telehealth Services list on a permanent basis: • GXXX1 (Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to CPT codes 99223, 99233, and 99236 for hospital inpatient or observation care evaluation and management services). • GXXX2 (Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to CPT codes 99306, 99310 for nursing facility evaluation and management services). • GXXX3 (Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to CPT codes 99345, 99350 for home or residence evaluation and management services). CMS added these codes because they are similar to current CPT codes 99356 and CPT 99357 and HCPCS code G2212, all listed on a permanent basis. Discontinue Reimbursement of Telephone (Audio-Only) E/M Services Under PHE waivers, CMS allowed separate reimbursement of telephone (audio-only) E/M services (CPT codes 99441-99443), something that was embraced by a sizeable cohort of practitioners and patients, particularly in rural areas or patients without suitable broadband access for audio-video. CMS rejected requests to permanently add these services to the Medicare Telehealth Services List. With the exception of certain telemental health services, CMS stated two-way interactive audio-video telecommunications technology will continue to be the Medicare requirement for telehealth services following the PHE. This is because Section 1834(m)(2)(A) of the Social Security Act requires telehealth services be analogous to in-person care by being capable of serving as a substitute for the face-to-face encounter. In CMS’ own language, “We believe that the statute requires that telehealth services be so analogous to in-person care such that the telehealth service is essentially a substitute for a face-to-face encounter.” As audio-only telephone is inherently non-face-to-face, CMS determined, that modality fails to meet the statutory standard. Therefore, 151 days after the PHE expires, audio-only telephone E/M services will revert to their pre-PHE “bundled” status under Medicare (i.e., covered but not separately payable). Practitioners will no longer receive separate reimbursement for these services. Discontinue the Use of Virtual Direct Supervision Under Medicare Part B, certain types of services (e.g., many diagnostic tests, services incident to physicians’ or practitioners’ professional services) must be furnished under the direct supervision of a physician or practitioner. For Medicare purposes, direct supervision requires the supervising professional to be physically present in the same office suite as the supervisee, and immediately available to furnish assistance and direction throughout the performance of the procedure. The supervising professional need not be present in the same room during the service, but the “immediate availability” requirement means in-person, physical - not virtual - availability. In connection with PHE waivers, CMS temporarily changed the direct supervision rules to allow the supervising professional to be remote and use real-time, interactive audio-video technology. That change did not require the professional’s real-time presence at, or live observation of, the service via interactive audio-video technology throughout the performance of the procedure. This change was temporary because CMS was concerned widespread direct supervision through virtual presence may not be safe for some clinical situations. In its proposed PFS rule, CMS rejected requests to make virtual direct supervision a permanent feature in Medicare. CMS is considering whether or not it should make virtual direct supervision a permanent feature of Medicare at some point in the future. Interested stakeholders with data are invited to submit comments and information to CMS on this topic. If the proposed rule is finalized, virtual direct supervision will expire at the end of the calendar year in which the PHE ends. If the PHE ends in October 2022, the supervision waiver will end December 31, 2022. If the PHE ends in January 2023, the supervision waiver will end December 31, 2023. Postpone the Effective Date of the Telemental Health Six-Month Rule Until 151 Days After PHE Ends In 2020, Congress imposed new conditions on telemental health coverage under Medicare, creating an in-person exam requirement alongside coverage of telemental health services when the patient is located at home. Under the rule, Medicare will cover a telehealth service delivered while the patient is located at home if the following conditions are met: The practitioner conducts an in-person exam of the patient within the six months before the initial telehealth service; The telehealth service is furnished for purposes of diagnosis, evaluation, or treatment of a mental health disorder (other than for treatment of a diagnosed substance use disorder (SUD) or co-occurring mental health disorder); and The practitioner conducts at least one in-person service every 12 months of each follow-up telehealth service. For a full understanding of the rule, read the frequently asked questions and what it means for practitioners at Medicare Telehealth Mental Health FAQs. This rule was originally scheduled to take effect the day after the PHE expires. Following an amendment to the rule, it is now set to take effect 151 days after the PHE expires. Extend Coverage of the Temporary Telehealth Codes Until 151 Days After the PHE Ends Temporary telehealth codes are those services added to the Medicare Telehealth Services List during the PHE on a temporary basis, but which were not placed into Category 1, 2, or 3. Coverage of those temporary telehealth codes had been scheduled to end when the PHE expires. In its proposed PFS rule, CMS states it will extend coverage of those temporary telehealth codes until 151 days after the PHE ends. CMS is doing so for consistency with the Consolidated Appropriations Act, 2022 (CAA). CMS stated this extension may simplify the post-PHE transition by applying the same coverage end date to all the various waiver-related telehealth codes in a hope to reduce billing errors. Note, the Category 3 codes are set to expire December 31, 2023, while the other temporary telehealth codes are set to expire 151 days after the PHE ends. This means, under the proposed rule, if the PHE ends after August 2023, the Category 3 codes would expire before the temporary telehealth codes. If finalized, health care providers would need to keep a careful eye on the calendar to ensure billing practices keep up with the various sunset dates. Add 54 Codes to the Category 3 Telehealth List CMS’ Category 3 list contains services that likely have a clinical benefit when furnished via telehealth, but lack sufficient evidence to justify permanent coverage. CMS proposed adding 54 codes to that Category 3 list. The services fall into nine categories: (1) therapy; (2) electronic analysis of implanted neurostimulator pulse generator/transmitter; (3) adaptive behavior treatment and behavior identification assessment; (4) behavioral health; (5) ophthalmologic; (6) cognition; (7) ventilator management; (8) speech therapy; and (9) audiologic. The complete list can be found at this link. Keep in mind, these codes will expire December 31, 2023.Category 3 codes were originally slated to expire at the end of the year in which the PHE ends, but CMS extended coverage of those codes through December 31, 2023. In this year’s proposed PFS rule, CMS declined any further extension, so all Category 3 codes will expire at the end of 2023. In the event the PHE extends well into 2023, CMS said it will consider a further extension of the Category 3 codes at that time. What to Do Next? Providers, facilities, technology companies, and virtual care entrepreneurs interested in changes to the telehealth codes for 2023 should consider providing comments to the proposed rule. CMS is soliciting comments on the proposed rule until 5:00 p.m. ET on September 6, 2022. Anyone may submit comments – anonymously or otherwise – via electronic submission at this link. Alternatively, commenters may submit comments by mail to: Regular Mail: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1770-P, P.O. Box 8016, Baltimore, MD 21244-8016. Express Overnight Mail: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1770-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850 If submitting via mail, please be sure to allow time for comments to be received before the closing date. For original article: https://www.natlawreview.com/article/medicare-telehealth-services-2023-cms-proposes-substantial-changes < Previous News Next News >

Trends in Telehealth: CCHP's 50 State Telehealth Policy Summary Report, Fall 2022 Center for Connected Health Policy October 18, 2022 Today the Center for Connected Health Policy (CCHP) is releasing its bi-annual summary of state telehealth policy changes for Fall 2022. Additionally, we are also making available a summary chart showing where states stand on many key telehealth policies, as well as an infographic highlighting our key findings. The most current information in CCHP’s online policy finder tool may be exported for each state into a PDF document. The Fall 2022 summary report adds in two new jurisdictions, Puerto Rico and Virgin Islands, and covers updates in state telehealth policy made between July and early September 2022. Note that in some cases, after a state was reviewed by CCHP, it is possible that the state may have passed a significant piece of legislation or implemented an administrative policy change that CCHP may not have captured. In those instances, the changes will be reviewed and catalogued in the upcoming Spring 2023 edition of CCHP’s Summary Report. As in previous editions, information in the policy finder remains organized into three categories: Medicaid reimbursement, private payer laws and professional requirements. Additionally, for this edition, CCHP received support from the National Association of Community Health Centers (NACHC) through funding from the Health Resources and Services Administration (HRSA) to create a specific category on federally qualified health center (FQHC) Medicaid fee-for-service policies. FQHCs have many unique rules that apply to them that sometimes effect their ability to utilize telehealth, such as the definition of a visit/encounter in the Medicaid program. The new FQHC category takes these considerations into account and will help FQHCs be able to more easily navigate to the policies that specifically affect them. See full article: https://mailchi.mp/cchpca/just-released-cchps-50-state-telehealth-policy-summary-report-fall-2022trends-in-telehealth-policy < Previous News Next News >

CCHP: Audio only vs. Live Video Use... Center for Connected Health Policy February 15, 2022 The National Telehealth Policy Resource Center The Office of the Assistant Secretary for Planning and Evaluation (ASPE) Office of Health Policy recently released a new Issue Brief titled National Survey Trends in Telehealth Use in 2021: Disparities in Utilization and Audio vs. Video Services. The analysis found a number of trends that can be helpful in understanding remaining telehealth barriers and their interaction with health care disparities. Utilizing Census Bureau’s Household Pulse Survey (HPS) information from 2021, the study focused on differences in use between live video and audio-only telehealth modalities. Overall findings showed that telehealth use was common and utilization rates were generally similar across most demographic subgroups, except those that were uninsured. Utilization rates of live-video telehealth, however, were found to be lower among underserved populations, such as those with lower incomes and Black, Latino, and Asian respondents. To read the full article: https://mailchi.mp/cchpca/new-aspe-issue-brief-addresses-audio-only-vs-live-video-use-and-interaction-with-healthcare-disparities < Previous News Next News >

Memorial Hermann to provide school-based pediatric telehealth Naomi Diaz October 18, 2022 Houston-based Children's Memorial Hermann has partnered with telehealth company Hazel Health to provide outpatient pediatric care to K-12 students in Houston. Under the partnership, schools that have agreements with Hazel will be able to offer their students access to health services via virtual telehealth sessions, according to an Oct. 17 press release. Children's Memorial Hermann pediatricians or specialists will connect with the students through the program for follow-up or long-term care management. The aim of the partnership is to increase access to pediatric care in schools across 12 counties in southeast Texas. See original article: https://www.beckershospitalreview.com/telehealth/memorial-hermann-to-provide-school-based-pediatric-telehealth.html < Previous News Next News >

How Does a Telemedicine Pain Program Work in Rural American with Multi-Vulnerable Patient Populations? Dax Trujillo, MD July 20, 2022 In April 2017 Summit Healthcare started a multi-disciplinary program to treat patients with chronic and acute pain in the White Mountains of Arizona. Our patient service area is HRSA-designated as having a shortage of providers and medically underserved. The area is the size of Rhode Island and includes Native American reservations and other vulnerable populations. Many of our patients live in a high poverty area which makes access to care challenging. In order to provide multi-disciplinary services that include interventional procedures, monitored medication management and cognitive behavior therapy, we needed to create a hybrid program. Our program incorporates in-person, video/audio and telephone visits. By using three different modes of care delivery we were able to reach and follow more patients with better outcomes. Since April 1, 2017 we have had over 900 patients participate in our telemedicine pain program. The visits include virtual appointments for medical management, behavioral therapy, and general wellness checks after an in-person visit; virtual check-ins for procedure or testing follow-ups and eVisits via email communication to answer questions and/or review prescription issues or re-ordering. Due to the rurality of the service area we estimate that patients were saved from having to travel 66,144 miles to a physician’s office. This was a significant relief to patients with limited means to transportation, knowing that their weekly, monthly in-patient visits were reduced to quarterly in-patient visits. Patient satisfaction has been high due to the reduction of travel time and costs. Simultaneously, the patient perceived they were being more closely monitored and their pain issues addressed in a timely manner. Another benefit is that more than one professional can join a telemedicine visit with the patient which allows a more holistic and comprehensive visit for better value based care of the patient. By providing virtual visits as part of the entire treatment program, we have saved thousands of dollars in chronic pain treatment costs. Through evidence-based research we know that patients are achieving better healthcare outcomes in this hybrid program by incorporating telemedicine technology. Our program has had overall success with addressing pain but there are some risks involved that must be addressed within your institution to provide a platform that is HIPPA compliant and protects critical sensitive health information. Providing a secure platform must be a top priority when delivering pain treatment virtually due to the sensitive nature of the disease/treatments with this patient population. While most patients do well with the hybrid program we do have patients for whom it is not appropriate. Due to our location, a subset of patients do not have access to broadband internet service so we cannot perform visits via video or sometimes audio. Other patients have expressed a preference for in-person visits while another group prefers all visits to be virtual. Patients needing neuraxial interventions or surgeries will need to be seen in-person. Each patient has their own unique circumstances so having a hybrid pain treatment program with various care delivery options allows us to reach more patients previously not being treated for their chronic pain issues. In the future we will purchase a remote patient monitoring platform/equipment that can be used with our chronic pain patients to better track their vitals, physical and mental health. This will also allow us to manage medications and behavioral issues related to pain and opioid addiction, both of which are prevalent in our service area. Our hospital system is also developing a hospital at home program which will incorporate the telemedicine pain program for patients with co-morbidities. The future of healthcare access is using hybrid delivery of care systems that include telemedicine, to improve accessibility and outcomes for chronic pain patients. For original article: https://southwesttrc.org/blog/2022/how-does-telemedicine-pain-program-work-rural-american-multi-vulnerable-patient < Previous News Next News >

Can digital health increase accessibility as mental health needs soar? HIMSS TV December 23, 2021 Deep Dive: Many adults with a mental illness won’t be able to access care, given greater levels of anxiety and depression during the pandemic. Digital tools can help. Learn more here: https://www.healthcareitnews.com/video/can-digital-health-increase-accessibility-mental-health-needs-soar < Previous News Next News >

Update on Risks of Payments in Arrangements With Telemedicine Companies: OIG Warns of Prosecution Risks and Identifies Seven Criteria for Caution When Entering Into Telemedicine Payment Arrangements, and the Advancing Telehealth Beyond COVID-19 Act Passes Andrea M. Ferrari, Nadia de la Houssaye August 26, 2022 On July 20, 2022, the Office of Inspector General of the US Department of Health & Human Services (OIG) issued a Special Fraud Alert urging healthcare practitioners to exercise caution when entering into arrangements with telemedicine companies. OIG issued this Special Fraud Alert the same day the US Department of Justice (DOJ) announced criminal charges against 36 defendants in 13 federal districts as part of the DOJ’s Nationwide Coordinated Law Enforcement Effort to Combat Telemedicine, Clinical Laboratory, and Durable Medical Equipment Fraud.[1] The Special Fraud Alert notes that OIG has recently conducted dozens of investigations of alleged fraud schemes involving companies that provide telehealth, telemedicine, or telemarketing services (collectively, Telemedicine Companies). It also notes that in many of these investigations, OIG found evidence that the Telemedicine Companies intentionally paid physicians and non-physician practitioners (collectively, Practitioners) kickbacks to generate orders or prescriptions for medically unnecessary durable medical equipment, genetic testing, wound care items, or prescription medications. The Special Fraud Alert warns that such kickback schemes implicate the federal Anti-Kickback Statute and can lead to Practitioners, Telemedicine Companies, and others that participate in the schemes being held liable criminally, civilly, and administratively. Liability may arise from (1) paying or receiving payment in violation of the federal Anti-Kickback Statute; and (2) causing submission of fraudulent claims to federal healthcare programs such as Medicare, Medicaid, and Tricare, which may constitute a violation of the federal False Claims Act and other federal laws. As a cautionary guide, the Special Fraud Alert identifies seven arrangement characteristics that may raise OIG scrutiny: 1. The patients for whom a Practitioner orders or prescribes items or services are identified or recruited by a Telemedicine Company, sales agent, recruiter, call center, or health fair, and/or through internet, television, or social media advertising for free or low-cost out-of-pocket items or services. 2. A Practitioner does not have sufficient contact with or information from the purported patient to meaningfully assess the medical necessity of the items or services ordered or prescribed. 3. A Telemedicine Company compensates a Practitioner based on the volume of items or services ordered or prescribed, which may be characterized to the Practitioner as compensation based on the number of medical records that the Practitioner reviewed. 4. A Telemedicine Company furnishes items and services only to federal healthcare program beneficiaries and does not accept insurance from any other payor. 5. A Telemedicine Company claims to furnish items and services only to individuals who are not federal healthcare program beneficiaries but may, in fact, bill federal healthcare programs. 6. A Telemedicine Company only furnishes one product or a single class of products (e.g., durable medical equipment, genetic testing, diabetic supplies, or various prescription creams), potentially restricting a Practitioner’s treatment options to a predetermined course of treatment. 7. A Telemedicine Company does not expect Practitioners to follow up with patients, nor does it provide Practitioners with the information required to follow up with patients (e.g., the Telemedicine Company does not require Practitioners to discuss genetic testing results with each purported patient). OIG advises in the Special Fraud Alert that this list of suspect criteria is illustrative and not exhaustive. Therefore, even arrangements that do not specifically fit one or more of these suspect criteria may still be suspect. However, OIG also indicates that it recognizes there are many legitimate telemedicine and telehealth arrangements, and explicitly states that the Special Fraud Alert is not intended to discourage those legitimate arrangements. Rather, OIG is using the Special Fraud Alert to encourage Practitioners (and, by extension, their advisors) to use heightened scrutiny, exercise caution, and consider the above list of suspect criteria before entering into arrangements with Telemedicine Companies. Telehealth Expansion Legislation Significantly, a week after OIG issued the Special Fraud Alert, the US House of Representatives overwhelmingly (416-12) passed the Advancing Telehealth Beyond COVID-19 Act of 2022 (HR 4040), which encourages broad use of telehealth by expanding and extending for at least an additional two years — through December 2024 — the Medicare telemedicine payment policies that were introduced for the COVID-19 public health emergency. The House bill removes geographic restrictions and expands originating sites for telehealth services, continues expansion of the practitioners eligible to provide telehealth services, allows mental health services to be provided via telehealth and telecommunications, and continues certain COVID-19 allowances for audio-only telehealth services. The bill is now pending in the Senate. [1] Press Release, US Department of Justice, Justice Department Charges Dozens for $1.2 Billion in Health Care Fraud (July 20, 2020), https://www.justice.gov/opa/pr/justice-department-charges-dozens-12-billion-health-care-fraud. © 2022 Jones Walker LLP National Law Review, Volume XII, Number 238 See Original article: https://www.natlawreview.com/article/update-risks-payments-arrangements-telemedicine-companies-oig-warns-prosecution < Previous News Next News >

Frequently Asked Questions Regarding Licensure & Telehealth Mei Wa Kwong, JD September 12, 2022 This video addresses the most frequently asked questions CCHP receives regarding licensure and telehealth for example: (1) What does the law says if your patient is going on vacation to another state, but still needs your services? (2) Do you really need a license in another state if you’re just consulting with a provider who is already licensed in that state? (3) ….and many more! View the PPT for this video here. See original video: https://www.cchpca.org/resources/frequently-asked-questions-regarding-licensure-telehealth/ < Previous News Next News >

Physician fee schedule final rule opens up telehealth access Susan Morse, Managing Editor, Healthcare Finance Nov. 5, 2021 AMA wants Congress to avert physician payment cuts it says will amount to 9.75% for 2022. For the first time outside of the COVID-19 public health emergency, Medicare will pay for mental health visits furnished by Rural Health Clinics and Federally Qualified Health Centers via telecommunications technology, including audio-only telephone calls. This will expand access for rural and other vulnerable populations. The Centers for Medicare and Medicaid Services announced this and other actions in the 2022 Physician Fee Schedule final rule released late Tuesday. In line with legislation enacted last year, CMS is eliminating geographic barriers and allowing patients at home to access telehealth services for diagnosis, evaluation and treatment of mental health disorders. Certain mental and behavioral health services via audio-only telephone calls that are being covered include counseling and therapy for the treatment of substance use disorders and services provided through opioid treatment programs. WHY THIS MATTERS While expanded telehealth coverage is supported by providers and others who responded to the final rule, the update to the clinical labor rates for 2022 got harsh feedback from the American Medical Association. With the budget neutrality adjustment to account for changes in Relative Value Units, as required by law, and expiration of the 3.75% temporary 2021 payment increase provided by the Consolidated Appropriations Act, the 2022 physician fee schedule conversion factor is $33.59, a decrease of $1.30 from the 2021 rate of $34.89. The AMA wants Congress to intervene to stop the physician payment cuts. "While the American Medical Association will thoroughly analyze the 2,400+ page rule, it is a reminder of the financial peril facing physician practices at the end of the year," said AMA president Dr. Gerald E. Harmon. "The final rule includes a reduction in the 2022 Medicare conversion factor of about 3.85%. "The AMA is strongly advocating for Congress to avert this and other looming cuts to Medicare physician payments that, overall, will produce a combined 9.75% cut for 2022. This comes at a time when physician practices are still recovering the personal and financial impacts of the COVID public health emergency." Other actions in the final rule include: Promoting growth in Medicare diabetes prevention program CMS is expanding the Medicare Diabetes Prevention Program (MDDP) model, in which local suppliers provide structured, coach-led sessions in community and healthcare settings using a Centers for Disease Control and Prevention-approved curriculum to provide training in dietary change, increased physical activity and weight-loss strategies. CMS is waiving the Medicare enrollment fee for all organizations that apply to enroll as an MDPP supplier on or after January 1, 2022. CMS has been waiving this fee during the COVID-19 PHE for new suppliers, and said it has witnessed increased supplier enrollment. The agency is shortening the model services period to one year instead of two years and is restructuring payments so suppliers receive larger payments for participants who reach milestones for attendance. Increased access to medical nutrition therapy services The PFS final rule also streamlines access to Medical Nutrition Therapy, which includes services provided by registered dietitians or nutrition professionals to help people with Medicare better manage their diabetes or renal disease. CMS has removed a requirement that limited who could refer people with Medicare to these services, allowing any physician to do so. This change should particularly benefit people living in rural areas as the services are provided to eligible individuals with no out-of-pocket costs and may be provided via telehealth. Encouraging vaccines to protect against preventable illness CMS will maintain the current payment rate of $40 per dose for the administration of the COVID-19 vaccines through the end of the calendar year in which the ongoing PHE ends. Effective January 1 of the year following the year in which the PHE ends, the payment rate for COVID-19 vaccine administration will be set at a rate to align with the payment rate for the administration of other Part B preventive vaccines. CMS will also continue to facilitate vaccinations for common diseases such as influenza, pneumonia, and hepatitis B. This year, Medicare reviewed payments for vaccinations to ensure doctors and other health professionals are paid appropriately for providing vaccinations. This final rule will nearly double Medicare Part B payment rates for influenza, pneumococcal and hepatitis B vaccine administration from roughly $17 to $30. Expanded pulmonary rehabilitation coverage As part of CMS' continuing efforts to address the current PHE, the agency finalized expanded coverage of outpatient pulmonary rehabilitation services, paid under Medicare Part B, to individuals who have had confirmed or suspected COVID-19 and experience persistent symptoms that include respiratory dysfunction for at least four weeks. This goes beyond the physician fee schedule proposed rule, which would have focused the expanded coverage to those hospitalized with COVID-19. CMS also finalized a temporary extension of certain cardiac and intensive cardiac rehabilitation services available via telehealth for people with Medicare until the end of December 2023. Advancing the Quality Payment Program and MIPS Value Pathways The final rule makes several changes to CMS' Quality Payment Program to promote the delivery of high-value care by clinicians through a combination of financial incentives and disincentives. For example, CMS finalized a higher performance threshold that clinicians will be required to exceed in 2022 to be eligible for positive payment incentives. This new threshold was determined in accordance with statutory requirements for the Merit-based Incentive Payment System. CMS has introduced the first seven MIPS Value Pathways in the clinical areas of rheumatology, stroke care and prevention, heart disease, chronic-disease management, lower-extremity joint repair (e.g. knee replacement), emergency medicine, and anesthesia. To incentivize high-quality care for professionals that are often key points of contact for underserved communities with acute healthcare needs, CMS has also revised the current eligible clinician definition to include clinical social workers and certified nurse-midwives among those participating in MIPS. Ensuring accurate payments through clinical labor update For the first time in nearly 20 years, CMS is updating the clinical labor rates that are used to calculate practice expense. As a result, payments to primary care specialists that involve more clinical labor, such as family practice, geriatrics, and internal medicine specialties, are expected to increase. There will be a four-year transition period to implement the clinical labor pricing update, which will help maintain payment stability and mitigate any potential negative effects on healthcare providers by gradually phasing in the changes over time. Increasing access to physician assistants' services Finally, CMS is implementing a recent statutory change that authorizes Medicare to make direct Medicare payments to Physician Assistants for professional services they furnish under Part B. For the first time, beginning January 1, 2022, PAs will be able to bill Medicare directly. THE LARGER TREND The final rule advances programs to improve the quality of care for people with Medicare by incentivizing clinicians to deliver improved outcomes. That will advance its strategic commitment to drive innovation to support health equity and high-quality, person-centered care, CMS said. ON THE RECORD "Promoting health equity, ensuring more people have access to comprehensive care, and providing innovative solutions to address our health system challenges are at the core of what we do at CMS," said CMS Administrator Chiquita Brooks-LaSure. "The Physician Fee Schedule final rule advances all these strategic priorities and helps build a better Medicare program for the future." https://www.healthcarefinancenews.com/news/cms-physician-payment-rule-promotes-greater-access-telehealth-services-diabetes-prevention#.YYK9zyVXS6A.twitter < Previous News Next News >

ATA AND ATA ACTION CO-LEAD LETTER TO THE U.S. SENATE SIGNED BY OVER 370 STAKEHOLDER ORGANIZATIONS SEEKING PERMANENCY FOR TELEHEALTH American Telemedicine Association September 13, 2022 WASHINGTON, DC, SEPTEMBER 13, 2022 – The American Telemedicine Association (ATA) and ATA Action co-led letter signed by 375 stakeholders urging the Senate to act this fall to ensure certainty for telehealth services. The letter asks the Senate to pass a two-year extension of the flexibilities and waivers allowing temporary access to telehealth put in place under the current public health emergency (PHE), while continuing to push for a permanent extension. Stakeholders are also pushing the Senate to include provisions to lift provider and patient location limitations, remove in-person requirements for telemental health, ensure continued access to clinically appropriate controlled substances without in-person requirements, and increase access to telehealth services in the commercial market, such as provisions in law set to expire at the end of the year that allow people with a high deductible health plan (HDHP) health savings account (HSA) to access telehealth coverage without first having to meet annual deductibles. The stakeholder letter was co-led by the Alliance for Connected Care, College of Healthcare Information Management Executives (CHIME), Connected Health Initiative, Consumer Technology Association, Executives for Health Innovation, Health Innovation Alliance, HIMSS, and Partnership to Advance Virtual Care. “This letter truly speaks from a strong, unified voice, representing the breadth of the healthcare industry. While we, over 375 strong, seek permanency for telehealth access, our hope is that the Senate will at least match the full two years of extensions envisioned by H.R. 4040,” said Kyle Zebley, senior vice president, public policy, the ATA, and executive director, ATA Action. “Further, in response to the recent actions of the House, the Senate should make great policies greater, by including those provisions left out of H.R. 4040. “Specifically, the Senate should make permanent, or at the very least extend the high deductible health plan (HDHP) health savings account (HSA) telehealth benefit set to expire at the end of the year and pass the remote prescribing provision to ensure continued access to clinically appropriate controlled substances without in-person requirements,” added Zebley. “When included with the policies recently passed with near unanimous support in the House, these additions will ensure Americans, particularly those in underserved and vulnerable communities, maintain access to quality healthcare.” To read a full copy of the stakeholder letter, please click here. About ATA Action ATA Action recognizes that telehealth and virtual care have the potential to transform the healthcare delivery system by improving patient outcomes, enhancing the safety and effectiveness of care, addressing health disparities, and reducing costs. ATA Action is a registered 501c6 company and an affiliated trade organization of the ATA. About the ATA As the only organization completely focused on advancing telehealth, theAmerican Telemedicine Association is committed to ensuring that everyone has access to safe, affordable, and appropriate care when and where they need it, enabling the system to do more good for more people. The ATA represents a broad and inclusive member network of leading healthcare delivery systems, academic institutions, technology solution providers and payers, as well as partner organizations and alliances, working to advance industry adoption of telehealth, promote responsible policy, advocate for government and market normalization, and provide education and resources to help integrate virtual care into emerging value-based delivery models. See full article: https://www.americantelemed.org/press-releases/ata-and-ata-action-co-lead-letter-to-the-u-s-senate-signed-by-over-370-stakeholder-organizations-seeking-permanency-for-telehealth/ < Previous News Next News >

Audio-Only Telehealth Visits During Pandemic Draw GAO Scrutiny Scott Mace October 03, 2022 The federal oversight agency recommends CMS adopt new coding procedures to compare care quality to in-person visits. With pandemic-fueled temporary waivers on telehealth leading to a surge in telehealth visits in 2020, especially on audio-only platforms, the practice is overdue for its own exam for effectiveness and privacy, according to a new Government Accounting Office (GAO) report. The use of telehealth services topped 53 million visits in the period between April and December 2020. During the same period in 2019, only 5 million such visits occurred. Many of those were conducted by phone or non-video telehealth, which was rarely allowed prior to the pandemic. [See also: CMS Proposes to Cut Audio_only Telehealth Coverage.] The Centers for Medicare & Medicaid Services has monitored some risks to program integrity related to these telehealth waivers, but the GAO report found that CMS "lacks complete data on the use of audio-only technology and telehealth visits furnished in beneficiaries' homes," in part because no billing mechanism exists to identify all these telehealth visits. "Providers are not required to use available codes to identify all instances of audio-only visits," the GAO reported. "Moreover, providers are not required to use available codes to identify visits furnished in beneficiaries' homes." The GAO said this coding is important to monitor the quality of these telehealth services as compared to equivalent in-person services. "CMS has not comprehensively assessed the quality of telehealth services delivered under the waivers and has no plans to do so, which is inconsistent with CMS' quality strategy," the GAO said. "Without an assessment of the quality of telehealth services, CMS may not be able to fully ensure that services lead to improved health outcomes." The GAO offered three recommendations for CMS going forward: 1. Develop a new billing modifier or make clearer how to bill audio-only office visits for better tracking; 2. Require providers to use existing site of service codes when beneficiaries receive Medicare telehealth services at home; and 3. Assess the quality of telehealth services delivered during the public health emergency. Finally, the GAO urged the Health and Human Services Department's Office of Civil Rights to offer additional education, outreach, and other resources to providers to help them explain risks to privacy and security that patients may face during telehealth visits. Scott Mace is a contributing writer for HealthLeaders. See original article: https://www.healthleadersmedia.com/technology/audio-only-telehealth-visits-during-pandemic-draw-gao-scrutiny < Previous News Next News >

OCR Clarifies Post-PHE HIPAA Compliance for Audio-Only Telehealth Center for Connected Health Policy June 21, 2022image The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) recently released guidance on the use of remote communication technologies for audio-only telehealth to assist health care providers and health plans, or covered entities, bound by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Breach Notification Rules (HIPAA Rules). The goal of the guidance as stated by OCR is to support continued access to audio-only telehealth post-public health emergency (PHE) and make clear that audio-only telehealth is permissible under HIPAA Rules. One of the main federal public health emergency (PHE) flexibilities instituted at the beginning of the pandemic included relaxed enforcement of certain federal privacy laws related to the use of various telehealth technologies (see OCR’s Notification of Enforcement Discretion for Telehealth Remote Communications (Telehealth Notification)). The Telehealth Notification states that OCR will not penalize providers under HIPAA related to their good faith use of audio or video remote communication technologies during the PHE. While it appears likely that the PHE will be further extended one more time until mid-October, this guidance seeks to prepare providers for a return to compliance once the PHE and enforcement relaxations are no longer in effect. HIPAA Allows Audio-Only OCR first and foremost confirms the ability to comply with HIPAA when using remote communications to provide audio-only telehealth services. The guidance states the expectation of privacy of protected health information (PHI) from impermissible uses or disclosures and the importance of providing telehealth services in private settings. If the setting is not fully private, however, it is stressed that other safeguards must be put in place, such as speaking in low voices and not using speakerphone functions. In addition, entities must verify the individual’s identity if they are unknown. While verification can be completed orally or in writing, the HIPAA Rules do not require any specific method of identity verification. The guidance also highlights that this requirement may entail the use of language assistance services with individuals with limited English proficiency. HIPAA Only Applies to Electronic Information via Electronic Media In addressing the need to meet HIPAA Security Rule requirements to use remote communication technologies, OCR clarifies that the Rule only applies to electronic PHI (ePHI) transmitted over electronic media. Therefore, the Rule does not apply to audio-only telehealth services provided over a traditional landline, however it does apply to landlines being replaced with Voice over Internet Protocol (VoIP) and other electronic technologies that involve the internet, cellular, and Wi-Fi, as well as smartphone apps and messaging services that electronically store audio messages. These requirements again only apply to covered entities, noting that patients receiving telehealth services via remote technologies are not obligated by HIPAA and therefore covered entities aren’t responsible for the privacy of information once it has been received by the patient’s device. To ensure compliance with the HIPAA Security Rule the guidance states that all potential risks should be identified and addressed as part of risk analysis and risk management processes required under HIPAA, including the risk for interception of information during transmission, the ability for devices to encrypt transmitted information, and other device security and authentication processes. Business Associate Agreements & Payer Rules A business associate agreement (BAA) with a telecommunication service provider (TSP) is not always necessary to utilize audio-only technologies, as long as the TSP is just a conduit for the PHI being transmitted and does not have the ability to access the information being shared. If, however, the provider wants to use an app that does store information, then a BAA is required with the app developer, including apps that may provide translation services. The guidance states that whether or not audio-only services are covered by the patient’s health insurer does not impact a provider’s ability to provide those services in compliance with HIPAA, as payer rules and requirements are separate from HIPAA Rules. While continuation of PHE telehealth flexibilities remains a policy focus in Congress, it is likely that the flexibilities related to privacy enforcement will not be continued post-PHE making the technologies used to provide telehealth services an area of focus for providers looking to continue providing telehealth access moving forward. Continuing use of audio-only telehealth is also an area of policy focus post-PHE, therefore this guidance is very timely. While the guidance is technically specific to just one telehealth modality, it does speak to audio-only through electronic technologies, generally encapsulating other remote communications using electronic means, such as video and store-and-forward telehealth. For more information on OCR’s guidance related to audio-only communications post-PHE, as well as general telehealth guidance, please view the OCR FAQs and other resources listed in their entirety. For more information: https://mailchi.mp/cchpca/ocr-clarifies-post-phe-hipaa-compliance-for-audio-only-telehealth < Previous News Next News >