Managing the COVID-19 pandemic is a moving target for most healthcare organizations. There are updates almost daily as cities, counties, states, and the federal government seek to both track and curb the spread. We'll be providing regular updates to summarize some of the key issues affecting providers.
The Trump administration has relaxed restrictions for telemedicine visits. Previously, Medicare has limited coverage for telehealth and virtual visits. To reduce the need for patients to be seen in the office and exposed to the virus, there is now more coverage for these visits. Medicare will now cover Medicare telehealth visits, virtual check-ins, and e-visits. Providers can now do a visit using video or audio to assess a patient and determine if they need to come in. Patients can also initiate a non-face-to-face visit through a tool like a portal at their convenience and the provide can recommend follow up care, a virtual visit, or an in person visit. You can find more information in the Medicare telemedicine healthcare provider fact sheet and the Medicare FAQ on telehealth waivers. MGMA Government Affairs has developed a resource to help organization understand the changes to telehealth.
Relaxed HIPAA Penalties
The Department of Health and Human Services’ Office for Civil Rights (OCR) will not impose penalties for noncompliance with HIPAA regulations as providers use telehealth platforms that may not comply with privacy rules during the pandemic. While telehealth rules have been loosened, many lack the technology to use it. With the relaxed HIPAA enforcement, providers can use tools that patients already havel like Skype and Google Hangouts.
States and the federal government have been looking at ways to expand coverage and reduce barriers to care during the outbreak. The declaration of a state of emergency has given the Department of Health and Human Services the ability to grant eleven different waivers, including lifting restrictions for critical access hospitals, skilled nursing facilities, acute care units, long-term care acute hospitals, and home health agencies as well as relaxing the requirements on durable medical equipment orders, provider sites, provider enrollment, and Medicare appeals. In addition, some states have asked tha tthe enrollment period for exchange programs be extended to allow people to access coverage in the fave of the outbreak.
The CDC has provided recommendations on how facilities can prepare for the COVID-19 outbreak and communicate with patients. "Provide updates about changes to your policies regarding appointments, providing non-urgent patient care by telephone, and visitors. Consider using your facility’s website or social media pages to share updates." Then, protect patients with these steps:
- Stay up-to-date on the best ways to manage patients with COVID-19.
- Separate patients with respiratory symptoms so they are not waiting among other patients seeking care. Identify a separate, well-ventilated space that allows waiting patients and visitors to be separated.
- Consider the strategies to prevent patients who can be cared for at home from coming to your facility potentially exposing themselves or others to germs, like:
- Using your telephone system to deliver messages to incoming callers about when to seek medical care at your facility, when to seek emergency care, and where to go for information about caring for a person with COVID at home.
- Adjusting your hours of operation to include telephone triage and follow-up of patients during a community outbreak.
- Leveraging telemedicine technologies and self-assessment tools.
Families First Coronavirus Response Act
President Trump as signed the Families First Coronavirus Response Act. It gives paid leave to those who did not have it and extends paid leave for those who has limited time off. The requirements are complex, but are summarize in this Washington Post article. The bill also provides for free COVID-19 testing and exapnds appropriations for meal programs like WIC, SNAP, and school, meals.
Additional legislation is in the works to provide more support to small business, medical providers, and those forced to stay home due to work and school closures. Watch for further updates as more information becomes available.