Telemedicine Makes Its Mark in 2020

In response to the emerging threat of the COVID-19 virus, both President Trump and Alex Azar, Secretary of Health and Human Services (HHS), made national health emergency declarations at the end of January. These actions automatically and collectively allowed the federal government to activate resources to assist state and local governments in their attempts to reduce the spread of the virus and mitigate economic losses. Under these declarations, additional statutory authorities were also triggered.

Increased use of telemedicine soon followed.

Risk Management Lessons from Litigated Cases
Get Medicine on Trial, a free publication of more than 80 litigated cases summarized by CAP's General Counsel Gordon Ownby.

With the health emergency declared, on March 17th Secretary Azar proceeded to issue multiple waivers under his authority of the Centers for Medicaid and Medicare Services (CMS) to quickly expand access to and use of telehealth services for Medicare recipients. Waivers expanded coverage while also waiving HIPAA penalties for “good faith” use of telehealth during the current emergency. The urgency the health crisis has presented to keep individuals in their homes has given way to an almost frenzied use of telehealth services since it offers a unique capacity for remote screening, triage, monitoring, and treatment, and has shown to be a powerful tool for reducing the transmission of the novel coronavirus to and among healthcare workers and those not infected.   

CMS continued to release waivers providing flexibilities that have now become very popular with both patients and providers. Patients can be seen while sitting in their homes with “visits” conducted through FaceTime, Skype, or other commonly used video conferencing apps and platforms (in California, public-facing apps such as Facebook Live cannot be used). Recognizing that older patients may not commonly use these technologies, a later waiver allowed for telephone consultations to be paid at the higher rate of an in-person visit. Another big change has been the allowance of expanding telehealth to new patients without the original requirement of having to be seen first in the office. Clearly, the technology is helping to fill the gap in care created by the health emergency but a major contributor to practices now being able to so quickly implement telehealth is quite likely the official pull back from very restrictive regulations.

Commercial insurers have also followed suit and expanded their own telehealth coverages and paid services, helping to strengthen revenue sources for the many practices that saw a huge dive in physical visits and with it, decreased revenues.

Providers have made very good use of the waivers to establish and increase the use of telemedicine in their practices, allowing them to remain connected to their patients and keeping their “virtual” doors open. Telemedicine and virtual care by thousands of medical practices across the country not only quickly became a critical way of delivering patient care in this pandemic, but is helping to mitigate the harsh economic blow by keeping physician practices afloat during a public health emergency that has turned into a global financial crisis.

These waivers will remain in place through the duration of the emergency health declaration. With the strong likelihood of “a second wave” of this pandemic and the clear warnings by health authorities of a compounded impact during the upcoming flu season, telemedicine will continue its vital role in the delivery of care for the foreseeable future . . . and beyond.   

Gabriela Villanueva is CAP’s Government & External Affairs Specialist. Questions or comments related to this article should be directed to gvillanueva@CAPphysicians.com.