COVID-19 and Telehealth: CMS Expands Access, New Funding Available 

CAST | April 20, 2020 | by Donna Childress

Nursing home intake and discharge visits, and home visits, are now covered. New funding is available for connected care services. Free telehealth access from a provider is among these resources.

As the COVID-19 pandemic evolves, we are seeing expanded coverage for Medicare beneficiaries and unprecedented demand for telehealth services. Here are the latest updates, along with news on how to receive free telehealth services.

CMS Expands Telehealth for Medicare Beneficiaries and Nursing Home Residents 

On March 30, 2020, the Centers for Medicare & Medicaid Services (CMS) released rules and waivers of federal requirements to manage potential surges of COVID-19 patients, including expanded access to telehealth for Medicare beneficiaries.
 
A CMS fact sheet notes that CMS will now pay for more than 80 additional services when furnished via telehealth. These include emergency department visits, initial nursing facility and discharge visits, and home visits, which must be provided by a clinician that is allowed to provide telehealth.
 
Providers can evaluate beneficiaries who have audio phones only. However, in order to bill for an office visit or other approved telehealth services, an interactive, real-time audio and video telecommunication system must be used. Clinicians can provide remote patient monitoring services for COVID-19 or a chronic condition.
 
A CMS fact sheet for long-term care facilities notes that physicians and non-physician practitioners can now conduct visits with nursing home residents by telehealth.
 
On April 3, CMS released a video on the Medicare telehealth services benefit, with answers to common questions.

$200 Million Available to Furnish Connected Care Services

Applications are now open through the Federal Communications Commission (FCC) for the COVID-19 Telehealth Program to Support Healthcare Providers, which will help skilled nursing facilities and other nonprofit healthcare providers to purchase telecommunications services, information services, and devices necessary to provide connected care services, both for the treatment of coronavirus and other conditions that occur over the course of the pandemic. 

The FCC’s $200 million program will only help fund monitoring devices that are already connected and able to automatically share data, rather than unconnected devices that patients use at home, to share results with their medical professional remotely. The funds were included in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Learn more about the application process, and apply today.

Please Contact Congress Today in Support of Home Health Providers - LeadingAge Action Alert

Congress is now developing the next COVID-19 relief package, and home health visits by telehealth need to be available. 

Home health agencies are a crucial discharge destination for the health care system, with hospitals needing every available bed to treat patients suffering from COVID-19. 

Urge Congress to expand home health emergency telehealth authority to allow for payment. It is critical that home health agencies be able to count telehealth visits as part of a unit of service, especially since they anticipate serving patients released from the hospital or sheltering at home with COVID-19. Please ask that Congress allow for home health telehealth visits to be equivalent to an in-person visit for the purposes of payment for the duration of the crisis.

Email your members of Congress today!

CAST Resources

A Telehealth, Telemedicine & Remote Patient Monitoring QuickCast by CAST Executive Director Majd Alwan, Ph.D., discusses the many new flexibilities to provide telehealth that are stemming from the COVID-19 pandemic. It also offers advice targeted to providers:

  • Independent Living: Make sure your residents know about and take advantage of these new telehealth options to access healthcare services safely.
  • Skilled Nursing and Assisted Living: Explore these options with your healthcare partners, including medical directors, physicians, and hospitals they work with. Make sure you have HIPAA-compliant and FDA-cleared/listed telehealth technologies and equipment and applications compatible with those of the distant telehealth provider, plus appropriate connectivity and bandwidth.
  • Home Health & Hospice: Explore FDA-Cleared/Listed biometric remote patient monitoring (RPM), as well as complementary medication adherence technologies, mobile point of care devices for staff, and partnerships with physicians on chronic care management and palliative care.

If you have not used telehealth or don’t have the equipment, explore the above-mentioned FCC’s COVID-19 Telehealth Program grant opportunity mentioned above. If you are considering a new telehealth solution, the LeadingAge CAST Telehealth and RPM Selection Tool will help you to choose the right technology for your organization’s needs.
 
Technology and Telehealth are part of LeadingAge's 2020 Policy Priorities, and we support the easing of telehealth restrictions to assist with COVID-19 response. To learn more about the new flexibilities, please see the LeadingAge COVID-19 Telehealth Waiver information.

Please Let CAST Know If You’re Using Telehealth More, or for the First Time

Also, if you have recently started using telehealth, or have increased the use of telehealth, in response to the circumstances created by the COVID-19 Pandemic, CAST would like to hear from you! Please feel free to email CAST Executive Director Majd Alwan, Ph.D., at malwan@LeadingAge.org. He looks forward to hearing from you.

Demand Grows for Telehealth Solutions; Free Telehealth Access Offered

Telehealth providers are seeing large demand, according to “No Turning Back: Senior Living Finally Enters Digital Age as a Result of Covid-19.”
 
The Senior Housing News article points to a comment made by Grant Chamberlain, managing director of healthcare investment at Ziegler, in a March 25 webinar: “There will be more advancement in telehealth between mid-March and mid-April than there has been in the last three years and it was already advancing dramatically.” Ziegler is a LeadingAge Gold Partner with CAST Focus.
 
In a partnership with Ziegler Link-Age Funds, VitalTech, which measures vital signs and improves resident monitoring, is offering senior living and long-term care facilities free 90-day access to the VitalCare telehealth platform.
 
Other opportunities in telehealth include using video conferencing to connect caregivers with patients and incorporating predictive analytics into telehealth platforms to measure entire communities, said Senior Housing News.

Perceptions of Telehealth Shift with COVID-19

Recent research found that COVID-19 may be changing perceptions of telehealth. For “Americans’ Perceptions of Telehealth in the Era of COVID-19,” Sykes surveyed 2,000 American adults on March 19-20, 2020.
 
Respondents in the 55+ age group were less likely to have used telehealth or expressed concerns about its effectiveness, said the Sykes summary. Some expressed concern that telehealth would only be effective for minor illnesses and diagnoses.
 
Of all respondents, 38% like the idea of being able to get a potential diagnosis without being around others who are sick in a waiting room. Those in the 55+ age group were most likely to say that situation is one of the main advantages of telehealth.
 
Senior Housing News shared unpublished survey data in its bulletin on April 8, 2020, noting that out of about 400 respondents over the age of 55, 52% said COVID-19 has increased their willingness to try telehealth. About 50% of older adult respondents said they would consider a telehealth appointment, although only about 12% have had one already. And 43% of respondents over age 55 said their biggest telehealth deterrent was doubt they could be properly diagnosed or treated via telehealth.