Telemedicine, the practice of virtually consulting with your health care provider through electronic means—such as email or video chat—is a growing industry. But according to a July 2019 survey conducted by J.D. Power, nearly three-quarters of Americans said that they had never heard of telehealth services or didn’t have access to them. That might be changing as a result of the recent coronavirus (COVID-19) outbreak.
With the spread of coronavirus across the United States, government and public health officials have urged people to stay home and engage in social distancing in order to slow the spread of the disease—and to conserve scarce hospital resources for the anticipated influx of COVID-19 patients. But these same officials recognize that people still need access to health care—not only for coronavirus assessments and treatments, but also for routine illnesses and injuries. And that’s where the expansion of telemedicine comes in.
The Federal Government: Expanding Access to Telemedicine for Medicare Recipients and Relaxing HIPAA Enforcement
Prior to the coronavirus crisis, the Center for Medicare & Medicaid Services (CMS) would pay for telemedicine for Medicare recipients in very limited circumstances, such as when a patient received care in a designated rural area and went to a clinic, hospital, or other medical facility to obtain the service. In response to the spread of coronavirus, effective March 6, 2020, CMS waived all geographic and location restrictions on telehealth services provided by doctors, nurse practitioners, clinical psychologists, and clinical social workers. That means that health care providers can now conduct office, hospital, or other visits by telemedicine to patients in any location, including their homes, for coronavirus concerns as well as other medical conditions. (See the CMS Telemedicine Fact Sheet for more details about the changes to Medicare’s telemedicine policies in response to COVID-19.)
In addition, the U.S. Department of Health and Human Services (HHS) will temporarily be relaxing enforcement operations for noncompliance with certain provisions of the Health Insurance Portability Accountability Act (HIPAA) in connection with the provision of telehealth services. That means that, during the COVID-19 national emergency, covered health care providers will be permitted to communicate with patients through technologies that might not comply with patient confidentiality requirements under the law. Under these emergency rules, HHS is allowing health care providers to offer diagnostic and treatment services through products such as Apple FaceTime, Facebook Messenger, or Google Hangouts without penalty. Health care providers still should not, however, use public-facing platforms, such as Facebook Live, Twitch, or TikTok to communicate with their patients. (Read the full HHS press release.)
Individual States Loosen Rules for Access to Telemedicine
A number of states have also taken steps to relax the rules for the practice of telemedicine and access to telehealth services in response to the coronavirus pandemic. The Center for Connected Health Policy (CCHP) is maintaining a list of states that have expanded their residents’ access to telemedicine in response to COVID-19—if only temporarily.
As of this post, a majority of the states have taken at least some steps to remove barriers to patient access to telehealth services, although the specifics of the states’ approaches vary widely. Texas, for example, is permitting health care providers to use telemedicine—including only the telephone—to diagnose and treat patients, as well as order tests and prescribe medication in all circumstances for the duration of the disaster period. And Massachusetts is requiring all commercial health insurers, self-insured plans, and state-run health plans to cover all “clinically appropriate, medically necessary” services via telehealth for the duration of the state of emergency—and those services must be covered at the same rate as in-person care. And other states, including Alaska, have temporarily expanded telehealth coverage for Medicaid recipients only. (Check the CCHP list of COVID-19 related state actions to see what lawmakers in your area are doing to expand access to telemedicine during this time.)
As the coronavirus continues to spread across the country, more states could join those that have already relaxed their restrictions on the use of telemedicine in response to the pandemic. And it remains to be seen whether lawmakers will work to make any temporary expansion of access to telehealth services permanent once the crisis has subsided.