One of the most impactful tools that healthcare providers were given to maintain continuity of care through the social distancing of COVID-19 was the relaxing of restrictions on telehealth services. Almost every medical practice I work with has been taking advantage of these tools now that they are more readily accessible, and patient feedback has been overwhelmingly positive.
Among the greatest improvements is the enhanced reimbursement by Medicare for telehealth visits. Medicare reimbursements for telehealth during COVID-19 have been essentially equivalent to in-person visits, which has been a tremendous boost to providers who were faced with near-empty waiting rooms and a ban on elective procedures. Many commercial payors have been following Medicare’s lead and offering improved telehealth reimbursement as well.
On June 2, Centers for Medicare & Medicaid Services (CMS) head Seema Verma announced the President’s intent to continue widespread access to telehealth after the pandemic. While this delivery of service will look the same to patients, providers are facing a much different experience when the regulations return to pre-pandemic terms.
It is important to note that the waivers that relaxed the CMS telehealth restrictions did not eliminate or change the restrictions, but merely stated that the government would not enforce them during the COVID-19 crisis. This is the equivalent of a state announcing that speed limits are still the law, but they are not going to pull drivers over for speeding.
This leaves the door open for these restrictions to be put back in enforcement mode at any time. And with that return to tighter regulations comes added liability, compliance and revenue cycle issues for providers who want to continue to offer these services.
The telehealth “genie” has been struggling to get out of the bottle for quite some time, and COVID-19 was the catalyst that finally released it into mainstream consciousness. Now that the genie is out, and both providers and patients are realizing its many benefits, it is unlikely he will be pushed all the way back in with the same level of restrictions and obstacles as before. However, it is inevitable that the genie will eventually be forced to operate within its own distinct guidelines again.
In preparation for this, providers should begin to revise workflow and policies to comply with existing regulations. Telehealth regulations relate primarily to proving medical necessity, complying with documentation requirements, meeting privacy and security standards and maintaining accurate billing. Understanding these regulations and establishing policies and procedures to operate within them will save a practice valuable time and money when the healthcare industry begins to go back to normal levels of operation.
Providers should also review recent telehealth studies that report on what conditions lend themselves to better management when performed in person rather than by telehealth. Specific protocols should be developed now and evenly implemented once patients become more willing to return to the medical office. The office staff needs a clear understanding of when telehealth is an appropriate approach, and when a face-to-face visit should be required. These standards should be communicated to patients as they evolve.
Telehealth offers great promise for quality care during the COVID-19 crisis, as well as the “new normal” that follows. Preparation is key to ensure that providers are positioned to take advantage of this new-found opportunity, while also mitigating their regulatory and legal risks.
This article originally appeared in the June 15, 2020 issue of NJBIZ