Trump Administration and CMS Expand Telehealth During COVID-19 Pandemic

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In an April 30 press release, the Centers for Medicare & Medicaid Services (CMS) announced that at President Trump’s direction, and building on its recent efforts to help the U.S. healthcare system manage the COVID-19 pandemic, CMS has issued another round of regulatory waivers and rule changes to deliver expanded care to the nation’s seniors and provide flexibility to the healthcare system. These changes include continuing CMS’s efforts to further expand beneficiaries’ access to telehealth services.

CMS is taking action to ensure states and localities have the flexibilities they need to ramp up diagnostic testing and access to medical care, key precursors to ensuring a phased, safe, and gradual reopening of America, said the authors.

CMS’s goals during the pandemic are to 1) expand the healthcare workforce by removing barriers for physicians, nurses, and other clinicians to be readily hired from the local community or other states; 2) ensure that local hospitals and health systems have the capacity to handle COVID-19 patients through temporary expansion sites (also known as the CMS Hospital Without Walls initiative); 3) increase access to telehealth for Medicare patients so they can get care from their physicians and other clinicians while staying safely at home; 4) expand at-home and community-based testing to minimize transmission of COVID-19 among Medicare and Medicaid beneficiaries; and 5) put patients over paperwork by giving providers, healthcare facilities, Medicare Advantage and Part D plans, and states temporary relief from many reporting and audit requirements so they can focus on patient care.

According to the announcement, for the duration of the COVID-19 emergency, CMS is waiving limitations on the types of clinical practitioners that can furnish Medicare telehealth services. Prior to this change, only doctors, nurse practitioners, physician assistants, and certain others could deliver telehealth services. Now, other practitioners are able to provide telehealth services, including physical therapists, occupational therapists, and speech language pathologists.

Also, CMS previously announced that Medicare would pay for certain services conducted by audio-only telephone between beneficiaries and their doctors and other clinicians. Now, CMS is broadening that list to include many behavioral health and patient education services. CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14- $41 to about $46-$110. The payments are retroactive to March 1, 2020.

In a May 1 press release, the American Psychological Association applauded the Administration and CMS for expanding Medicare coverage for audio-only phone services during the coronavirus pandemic, including psychotherapy, health behavior assessment and intervention services, and other behavioral health services.

Previously, Medicare recipients who wanted to take advantage of psychotherapy through telehealth could do so only via videoconferencing. This was a significant limitation for people without access or capability to use those technologies

“To curb the spread of the coronavirus and help our communities heal, we cannot leave any of our neighbors behind,” said Arthur C. Evans Jr., PhD, CEO of the American Psychological Association. “The American Psychological Association is grateful to our members and congressional leaders on both sides of the aisle for tirelessly advocating for these needed phone services.”

“Psychologists can now use their specialty skills to improve the health of ALL the communities we serve, including older adults, people with lower income or education, individuals with disabilities and people in rural areas,” he added. “Yesterday, some of the most vulnerable people in our country did not have access to psychological care. Today, they do.”

For additional background information on the waivers and rule changes, go to: https://www.cms.gov/newsroom/factsheets/additional-backgroundsweepingregulatory-changes-help-us-healthcare-systemaddress-covid-19-patient

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