Update on Telehealth Changes and Resources

Due to the unprecedented disruption to the healthcare system caused by the COVID-19 pandemic, many physicians are being forced to consider alternative options to see patients and stay viable as a business. We recognize you may be dealing with patients who are uncomfortable or are being advised to not come to your offices.

For many of you this means considering some level of telehealth, and in most cases neither your practice or patients have any sophisticated means to do so. The simple question being asked by some practices is: “Can I legally interact with patients over the phone while they are sitting at home and get reimbursed for it?” The short answer is: Yes.

Medicare, Medicaid, private insurers and the medical board are actively making changes that will increase your flexibility in providing telehealth services and allow you to get reimbursed for it. Whether you are starting from scratch or expanding what you already do, the following update provides the latest information about what has changed, what we are working on changing, resources you can use and education we are planning. We have also established a dedicated section of our website www.osma.org/telehealth where we will be routinely adding information and resources.

Reimbursement and Regulatory Changes

Medicare

CMS has relaxed telehealth rules to make it easier for patients to consult with their physician using various virtual modalities in place of in-person visits. And physicians will be reimbursed for these virtual visits at the same rate as if it were an in-person medical visit, subject to state law.

The three main types of virtual services approved by CMS include: telehealth visits, virtual check-ins, and e-visits.

For telehealth visits, providers must use interactive audio and video technologies that permit real-time communications. Healthcare providers have the option of reducing or waiving deductibles. And patients do not have to have a prior relationship with the physician in order to consult with them.

For virtual check-ins, physicians will be allowed to bill for brief communications with their patients but only if a prior relationship existed. This could be done via telephone, email, or text messaging and the check-ins are not allowed to last more than 10 minutes.

E-visits are those patient consultations where an online patient portal is used for the communication. E-visits must be initiated by the patient and the communication can occur over a 7-day period. There are no geographical restrictions for patients who utilize this service.

Medicare Telehealth Fact Sheet

Medicare Telehealth FAQ

OIG Announcement Regarding Waiver of Beneficiary Costs

Medicaid

The Ohio Department of Medicaid will be making sweeping changes similar to Medicare that will liberalize the manner in which practices can provide services via telehealth and get paid for them. We anticipate these emergency rules being implemented this week and effective immediately. We also believe they will apply to the five Medicaid managed care plans operating in Ohio.

Commercial Insurance

The OSMA has been working with the governor’s office, the Department of Insurance and the major commercial insurance plans in Ohio to create policies similar to those announced by Medicare so that patients regardless of their coverage will be able to be seen via telehealth in this time of crisis and physicians will be paid for these encounters. We hope to have updates for you by the beginning of next week.

State Medical Board of Ohio

Today the Medical Board suspended enforcement of existing rules requiring an in-person visit prior to providing services via telemedicine.

HIPAA Enforcement

The Department of Health and Human Services Office of Civil Rights announced it won’t be enforcing certain aspects of HIPAA related to telehealth during the COVID-19 crisis. Specifically it differentiates those application types that will be allowed to be used with patients and those that can’t.

How-To and Educational Resources

For those who have no telehealth capabilities via a hospital or health system relationship, you CAN take advantage of telehealth visits with little or no cost and little effort. The AMA has developed an excellent quick guide with tips on getting started, coding and billing and other practice and policy considerations.

Additionally, the OSMA is developing a complimentary on-demand webinar that will explain the new telehealth rules, security and consent requirements, applications you can’t use, and the coding, documentation and reimbursement guidelines for telehealth visits. We plan on offering the webinar early next week so be watching for an email invitation by the end of this week or email us at info@osma.org and we will be sure to send details directly to you when they are available.

Finally, the OSMA is investigating products and services you can use, outside of your telephone and EHR, that are low-cost and offer immediate implementation.  We will be providing information on those soon on our webpage. Finally, as you begin the process of implementing telehealth in your practice we hope you will reach out to us with questions, concerns and ideas for additional information and educational resources we can provide in the future.

To opt-out of future OSMA updates on this topic, submit opt-out request.