March 18, 2020

Trump expands Medicare telehealth benefits as research warns of COVID-19 impact

Daily Briefing

    The Trump administration on Tuesday expanded telehealth benefits for Medicare beneficiaries and relaxed some HIPAA regulations as part of its response to the new coronavirus pandemic, as U.S. cases of COVID-19, the disease caused by the new virus, reached all 50 states and deaths tied to the virus topped 100.

    Are you ready to leverage telehealth against COVID-19? Here are 3 steps to prepare.

    US COVID-19 cases may be higher than current estimates

    Reports of COVID-19, the disease caused by the new coronavirus, first surfaced in early December 2019 in Wuhan, China.

    The United States saw its first COVID-19 case in late January, and cases have spiked since then. As of Wednesday morning, state and federal officials had reported 5,881 cases of COVID-19 and 107 deaths linked to the new coronavirus in the United States. Officials have now reported at least one case of COVID-19 in all 50 states and Washington, D.C., as well as in three U.S. territories.

    According to CNBC, state and local officials say it's likely the actual number of Americans with COVID-19 is drastically higher than what's been reported so far. Officials note that testing kits for the new coronavirus have been scarce in the United States, but as more tests become available, it's likely that the number of Americans with reported, confirmed cases of COVID-19 will continue to rise significantly.

    A report released Tuesday by Imperial College London estimated that, without action by the government and individuals to curb the new coronavirus' spread, as many as 2.2 million Americans could die from the virus. The researchers said the United States would need to implement stringent restrictions on social gatherings, school, and work across the entire country until a vaccine for the virus is available—which could take up to 18 months—to control the outbreak.

    Trump admin expands Medicare telehealth benefits, relaxes HIPAA rules

    The report from Imperial College London, which was reviewed by White House officials, pushed the Trump administration to release stricter social distancing recommendations on Monday and to ramp up other parts of its coronavirus response efforts, the New York Times reports.

    On Tuesday, CMS announced that, retroactive to March 6, it is expanding Medicare reimbursements for telehealth services, allowing clinicians to be paid for a wider range of telehealth services provided to beneficiaries in various settings throughout the United States. CMS Administrator Seema Verma said, "These changes allow seniors to communicate with their doctors without having to travel to a health care facility so that they can limit risk of exposure and spread of this virus. Clinicians on the frontlines will now have greater flexibility to safely treat our beneficiaries."

    Specifically, CMS said Medicare will now pay clinicians for telehealth services conducted "in any health care facility including a physician's office, hospital, nursing home, or rural health clinic, as well as from [beneficiaries'] homes." Further, the agency said it will now pay clinicians for "various services through telehealth including common office visits, mental health counseling, and preventive health screenings." Previously, Medicare would pay clinicians only for a limited scope of telehealth services, such as certain routine care visits, and only if beneficiaries met certain geographical requirements and received the services at a local medical facility.

    CMS said it will pay clinicians for the newly eligible telehealth services under the Physician Fee Schedule, at the same rate clinicians would receive if the services were provided in person. The agency said typical Medicare coinsurance and deductible requirements would apply for the services, but noted that HHS' Office of Inspector General is giving providers flexibility to reduce or waive cost-sharing requirements for telehealth visits covered by federal health care programs.

    In addition, HHS announced that its Office for Civil Rights effective immediately "will exercise enforcement discretion and waive penalties" for health care providers who use "everyday communications technologies, such as FaceTime or Skype," to "serve patients in good faith … during the COVID-19 nationwide public health emergency." HHS said although the communications technologies may not be fully compliant with HIPAA regulations, providers "can use any non-public facing remote communication product that is available to communicate with patients" during the public health emergency without being penalized for violating HIPAA.

    Trump admin eyes $1T emergency stimulus package, checks for Americans

    Meanwhile, Trump administration officials and Congress are working on aid packages that could provide as much as $1 trillion in emergency stimulus to help support Americans and U.S. businesses as the country grapples with the coronavirus pandemic—and that could include a proposal to send checks directly to Americans.

    According to Politico, White House officials have been working on a package that could provide $50 billion dollars in emergency stimulus funding to the airline industry, $250 billion for programs to support small businesses, and $500 billion to support Americans either through cutting the payroll tax or by sending them money directly.

    Department of the Treasury Secretary Steven Mnuchin on Tuesday said "Americans need cash now. And I mean now—in the next two weeks."

    According to Axios, it's unclear who would qualify for the funds or how much they would receive, but Mnuchin indicated the money would go to Americans most affected by the country's COVID-19 outbreak. "We don't need to send people who make a million dollars a year checks," he said.

    Some legislators have called for making direct payments of $1,000 to each American adult, but Mnuchin suggested the payments officials currently are considering "may be a little bit bigger than what's in the press," Axios reports (Johnson, The Hill, 3/17; Garrity, Becker's Health IT, 3/17; New York Times, 3/18; Smith et al., New York Times, 3/18; Wise, The Hill, 3/17; Feuer, CNBC, 3/17; Oprysko, Politico, 3/17; Ayesh, Axios, 3/17; Fink, New York Times, 3/16; CMS release, 3/17; CMS fact sheet, 3/17; HHS notification, 3/17; Cook/White, Politico, 3/17; Treene, Axios, 3/18).

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