Telehealth May Be Here to Stay

CAST | June 19, 2020 | by Donna Childress

We share predictions for the future of telehealth, as well as guidance for skilled nursing facilities.

The response to COVID-19 has increased access to telehealth, and those changes may be here to stay. Read on for expected changes in waivers, coming data privacy and cybersecurity concerns, guidance for skilled nursing facilities, and more.
But first, please tell LeadingAge CAST how you are using telehealth during the pandemic. Please take our one-question COVID-19 Telehealth Pulse Survey so that we can design resources to support you.

CMS May Extend Telehealth Waivers

The Centers for Medicare & Medicaid Services (CMS) is considering extending waivers on telehealth coverage past the pandemic, McKnight's Long-Term Care News reported, although doing so would require Congressional approval.
Centers for Medicare & Medicaid Services Administrator Seema Verma has confirmed this possibility. McKnight's reported that Verma spoke at a live virtual event with STAT News, saying “People recognize the value of this, so it seems like it would not be a good thing to force our beneficiaries to go back to in-person visits.”
Verma also raised the possibility of changes in reimbursement for telehealth visits after the pandemic. “I don’t see it as a one-to-one,” she reportedly told STAT News. “…I think there are some potential savings for the system that do occur by having a telehealth visit.”

Industry Changes in Telehealth

A recent HealthTech article titled "How Will Telehealth Change After the Pandemic?" says that you should prepare now and be ready to quickly adapt your telehealth. The following changes may be on the way. 

  • Heightened Data Privacy Laws: Expect data privacy and security laws to return to normal after the pandemic. HealthTech recommends providers prepare for more stringent privacy laws:
    • Evaluate security controls of telehealth technologies and vendor HIPAA compliance.
    • Consider interoperability of platforms and connected devices with electronic health record systems.
    • Enter into or amend business associate agreements with vendors who have access to protected health information and ensure protections for breaches and security incidents—including strong indemnification, reporting obligations, and cyber liability coverage.
    • Conduct a comprehensive security risk assessment of IT systems. 

For more on cybersecurity and how to protect your organization, see CAST's Cybersecurity Resources. The Cybersecurity White Paper, Case Studies, and a Self-benchmarking Questionnaire can help you to identify where your organization may be at risk so that you can plug vulnerabilities. These resources will also help you respond well if your organization is attacked. 

  • Continued Debate Over Reimbursement and Coverage Expansion: The COVID-19 pandemic may finally provide the data the Congressional Budget Office needs on telehealth in Medicare fee-for-service, and the favorable scoring Congress needs to expand Medicare coverage. HealthTech predicts Medicaid coverage expansion will vary by state and that increased state actions for payment and coverage parity for telehealth may occur on the commercial side.
  •  A Long-Term Focus on Care Delivery and Fraud Detection: Some states may continue waiving or relax restrictions on in-state licensure requirements for doctors and other disciplines. HealthTech also expects federal prescribing laws to revert to pre-pandemic status, at least in the short term.
  •  Increased Scrutiny of Telehealth: Government enforcers will be watching the telehealth space with interest, HealthTech warns, so providers should be aware of the federal Anti-Kickback Statute and telemedicine billing rules to avoid potential trouble. 

Guidance for SNFs

Long Term Care Leader has provided guidance for skilled nursing facilities (SNFs) using telehealth. “SNF Therapy Telehealth Waivers and other Updated COVID-19 Billing FAQ Updates” highlights FAQs of special importance to SNFs: 

  • Section L. Medicare Telehealth, starting on page 42, which contains several clarifications mostly related to physician services.
  • Section DD. Diagnosis Coding under International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), on pages 69-70, which indicate where to find the current resources.
  • Section FF. Outpatient Therapy Services, on pages 70-71, which Long Term Care Leader says finally clarifies that telehealth technology can be used to furnish PT, OT, and SLP services for both Medicare Part A and Part B services for facility-based providers including SNF. 

For more information, see the AHCA FAQs: SNF Therapy Telehealth Under COVID-19 Section 1135 Waivers, from the American Health Care Association and the National Center for Assisted Living.

More Predictions on a Post-Pandemic World

To learn more about coming changes to telehealth, read How COVID-19 and Technology Would Reshape our Future? by CAST Executive Director Majd Alwan, Ph.D., in this month’s issue of Tech Time.