How Telemedicine Requirements Have Changed to Address COVID-19

By: on April 6, 2020

By now, you’ve heard of the coronavirus outbreak, how heavily it continues to impact the U.S., and what a valuable tool telemedicine software has been in continuing to serve patients while minimizing the risk of spread.

Telemedicine is well-suited to address the coronavirus for two big reasons: 

  • Patients with COVID-19 symptoms can use it to seek care remotely while minimizing the risk of spreading the virus and ensuring they are able to be tested and treated.
  • Immunocompromised patients who are at a higher risk can use it to continue receiving treatment for chronic or ongoing conditions without risking exposure by physically going to the doctor’s office.

Fortunately, telemedicine was not a new technology when COVID-19 arrived in the U.S.—but unfortunately, it was also not a widely used tool at the time. Since then, legislators and medical providers have recognized the value of this software and made moves to expand adoption.

Since January, we’ve seen several legislative changes to how telemedicine can be coded and claimed for Medicare reimbursement. Understanding those changes is critical for independent practices hoping to implement telemedicine.

Here’s what we’ll cover:

  • A timeline of telemedicine regulation changes
  • What you should know about current telemedicine regulations
  • Finding the right telemedicine system

A timeline of telemedicine regulation changes

To gain an accurate understanding of the current regulations around telemedicine in the U.S., it’s helpful to understand where this software stood before COVID-19 hit the country and how legislation has evolved since that time to make it more accessible.



Pre-coronavirus: Telemedicine is highly regulated in the U.S.

Prior to the outbreak of COVID-19, U.S. doctors who wanted to use telemedicine technology faced a lot of regulatory obstacles from multi-state licensing and credentialing to coding, reimbursement, and privacy compliance.

These regulations were likely a big part of why relatively few practices utilized telemedicine to see patients and why adoption was widely limited to mental health specialties.

All that started to change in January of 2020.

January 21, 2020: First case of COVID-19 diagnosed in the U.S.

On January 21, a male patient in his 30s who had recently traveled to Wuhan, China, where the virus originated, was diagnosed in Washington state. Nine days later, on January 30, the World Health Organization (WHO) declared a global health emergency.

About a month later, on February 26, the Centers for Disease Control and Prevention (CDC) confirmed what was suspected to be the first case of local transmission in the U.S. with a Californian patient who had not traveled to an outbreak area and had no contact with anyone previously diagnosed with coronavirus.

Two days later, the first death of a coronavirus patient in the U.S. occurred.

March 6, 2020: Coronavirus Preparedness and Response Supplemental Appropriations Act passes

Early in March, Congress passed the first piece of coronavirus relief legislation: The Coronavirus Preparedness and Response Supplemental Appropriations Act.

Among other things, this legislation enabled Health and Human Services (HHS) Secretary Alex Azar to remove telehealth restrictions specifically for Medicare beneficiaries with the goal being to allow easier access to telemedicine for senior patients.

This was a big step in the deployment of telemedicine during the COVID-19 outbreak; however, it didn’t solve every problem.

March 27, 2020: CARES Act is signed into law

Finally, the Coronavirus Aid, Relief, and Economic Security (CARES) Act was passed by Congress and signed into law.

This legislation does a lot of different things for U.S. citizens, small businesses, doctors, and patients, not the least of which is expand Medicare coverage for telemedicine and provide new allowances for federally-qualified health centers (FQHCs), rural health clinics (RHCs), and hospice facilities.

With the CARES Act, Medicare patients are now able to access care from their homes (as opposed to a federally approved treatment center) whenever they need it.

What you should know about current telemedicine regulations

As an independent medical practice looking to implement telemedicine to continue treating your patients, you should be aware of several key changes made by the Centers for Medicare and Medicaid Services (CMS) and the HHS Office.

Medicare reimbursement: Medicare will now pay a broader range of providers (i.e., nurse practitioners, clinical psychologists, and social workers) for patient visits conducted via telemedicine. These virtual appointments will be reimbursed at the same rate as in-person visits for the time being.

Licensing flexibility: Previously, medical providers were required to be licensed in the state where the patient receiving treatment via telemedicine is located. According to the CMS telemedicine fact sheet, that requirement has been waived at this time to allow physicians to treat Medicare patients regardless of location. Additionally, providers may request a waiver to receive the same consideration for their Medicaid patients.

Relaxed HIPAA regulations: The HHS has stated that its HIPAA-enforcement branch (the Office of Civil Rights or the OCR) will exercise “enforcement discretion” at this time, which means that penalties will not be enforced for failure to comply with regulatory requirements during the “good faith provision of telehealth” during the COVID-19 pandemic. OCR Director Roger Severina said they are “empowering medical providers to serve patients wherever they are during this national public health emergency.”

It’s important to note that these regulation changes have been made on a “temporary and emergency basis” as stated by the CMS, so providers should not expect these current conditions to continue to apply after the COVID-19 pandemic has passed.

Finding the right telemedicine system

Now that you’re more familiar with the current regulations around telemedicine use in the U.S., you might be more inclined to start searching for a telemedicine system that you can deploy quickly.

If that’s the case, check out these resources to get started researching and identifying the products that will be best suited for your practice:

If your interest in telemedicine stems from COVID-19, selecting and implementing a system as quickly as possible should be your main goal—but not at the expense of due diligence. To expedite your telemedicine software research, reach out to our team of medical technology advisors.

You can either schedule a call or start a live chat to answer specific questions about your needs (e.g., budget and feature requirements), and they will provide you with a short list of telemedicine systems that meet your exact needs. From there, you’ll be able to jump ahead to next steps (such as product demos) and eventually select your software.

You may also like:

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What You Need to Know About Telemedicine in the World of COVID-19

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