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CENTERS FOR MEDICARE &
MEDICAID SERVICES (CMS)
 
Special
Edition – Tuesday, March 17, 2020
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President
Trump Expands Telehealth Benefits for Medicare Beneficiaries During
COVID-19
Outbreak
CMS
Outlines New Flexibilities Available to People with Medicare
The Trump Administration today announced
expanded Medicare telehealth coverage that will enable beneficiaries to
receive a wider range of healthcare services from their doctors without
having to travel to a healthcare facility. Beginning on March 6, 2020,
Medicare—administered by the Centers for Medicare & Medicaid Services
(CMS)—will temporarily pay clinicians to provide telehealth services for
beneficiaries residing across the entire country.
“The Trump Administration is taking swift and
bold action to give patients greater access to care through telehealth during
the COVID-19 outbreak,” said Administrator Seema Verma. “These changes allow
seniors to communicate with their doctors without having to travel to a
healthcare 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.”
On March 13, 2020, President Trump announced
an emergency declaration under the Stafford Act and the National Emergencies
Act. Consistent with President Trump’s emergency declaration, CMS is
expanding Medicare’s telehealth benefits under the 1135 waiver authority and
the Coronavirus Preparedness and Response Supplemental Appropriations Act.
This guidance and other recent actions by CMS provide regulatory flexibility
to ensure that all Americans—particularly high-risk individuals—are aware of
easy-to-use, accessible benefits that can help keep them healthy while
helping to contain the spread of coronavirus disease 2019 (COVID-19).
Prior to this announcement, Medicare was only
allowed to pay clinicians for telehealth services such as routine visits in
certain circumstances. For example, the beneficiary receiving the services
must live in a rural area and travel to a local medical facility to get
telehealth services from a doctor in a remote location. In addition, the
beneficiary would generally not be allowed to receive telehealth services in
their home.
The Trump Administration previously expanded
telehealth benefits. Over the last two years, Medicare expanded the ability
for clinicians to have brief check-ins with their patients through phone,
video chat and online patient portals, referred to as “virtual check-ins”.
These services are already available to beneficiaries and their physicians,
providing a great deal of flexibility, and an easy way for patients who are
concerned about illness to remain in their home avoiding exposure to others.
A range of healthcare providers, such as
doctors, nurse practitioners, clinical psychologists, and licensed clinical
social workers, will be able to offer telehealth to Medicare beneficiaries.
Beneficiaries will be able to receive telehealth services in any healthcare
facility including a physician’s office, hospital, nursing home or rural
health clinic, as well as from their homes.
Medicare beneficiaries will be able to
receive various services through telehealth including common office visits,
mental health counseling, and preventive health screenings. This will help
ensure Medicare beneficiaries, who are at a higher risk for COVID-19, are
able to visit with their doctor from their home, without having to go to a
doctor’s office or hospital which puts themselves or others at risk. This
change broadens telehealth flexibility without regard to the diagnosis of the
beneficiary, because at this critical point it is important to ensure
beneficiaries are following guidance from the CDC including practicing social
distancing to reduce the risk of COVID-19 transmission. This change will help
prevent vulnerable beneficiaries from unnecessarily entering a healthcare
facility when their needs can be met remotely.
President Trump’s announcement comes at a
critical time as these flexibilities will help healthcare institutions across
the nation offer some medical services to patients remotely, so that
healthcare facilities like emergency departments and doctor’s offices are
available to deal with the most urgent cases and reduce the risk of
additional infections. For example, a Medicare beneficiary can visit with a
doctor about their diabetes management or refilling a prescription using
telehealth without having to travel to the doctor’s office. As a result, the
doctor’s office is available to treat more people who need to be seen
in-person and it mitigates the spread of the virus.
As part of this announcement, patients will
now be able to access their doctors using a wider range of communication
tools including telephones that have audio and video capabilities, making it
easier for beneficiaries and doctors to connect.
Clinicians can bill immediately for dates of
service starting March 6, 2020. Telehealth services are paid under the
Physician Fee Schedule at the same amount as in-person services. Medicare
coinsurance and deductible still apply for these services. Additionally, the
HHS Office of Inspector General (OIG) is providing flexibility for healthcare
providers to reduce or waive cost-sharing for telehealth visits paid by
federal healthcare programs.
Medicaid already provides a great deal of
flexibility to states that wish to use telehealth services in their programs.
States can cover telehealth using various methods of communication such as
telephonic, video technology commonly available on smart phones and other
devices. No federal approval is needed for state Medicaid programs to
reimburse providers for telehealth services in the same manner or at the same
rate that states pay for face-to-face services.
This guidance follows on President Trump’s
call for all insurance companies to expand and clarify their policies around
telehealth.
To read the Fact Sheet on this announcement
visit: https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet
To read the Frequently Asked Questions on
this announcement visit: https://www.cms.gov/files/document/medicare-telehealth-frequently-asked-questions-faqs-31720.pdf
This guidance, and earlier CMS actions in
response to the COVID-19 virus, are part of the ongoing White House Task
Force efforts. To keep up with the important work the Task Force is doing in
response to COVID-19 click here https://protect2.fireeye.com/url?k=1dc3b044-4196b994-1dc3817b-0cc47a6a52de-daff918c3d41b4a0&u=http://www.coronavirus.gov/.
For information specific to CMS, please visit the Current Emergencies Website.
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