In an effort to fight the community spread of COVID-19, Federal and State lawmakers and regulators have worked to issue temporary waivers of the requirements related to telehealth services. Certain waivers have been instituted to make telehealth services more accessible. With the increase in access to telehealth services, healthcare providers will be able to see and treat patients while decreasing the need for unnecessary travel. Below is a discussion of the Federal telehealth waiver provisions as well as a discussion of Mississippi-specific waivers that have been issued. Given that states across the country are dealing with this same health crisis, if you have questions concerning any similar waivers issued in other states, please do not hesitate to contact our offices.
On March 6, 2020 the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 (“Act”), was signed in to law. This Act authorized emergency supplemental appropriations to combat COVID-19, and also included a specific division entitled “Division B - Telehealth Services During Certain Emergency Periods.” This division of the Act provided the Secretary of Health and Human Services the authority to temporarily waive or modify, during declared times of emergency, certain Medicare requirements related to the provision of telehealth services to Medicare beneficiaries.
In response to this Act and pursuant to its 1135 Waiver authority, on March 17, 2020, it was announced that the Centers for Medicare and Medicaid Services (“CMS”) would expand telehealth services to allow Medicare beneficiaries to more easily access needed healthcare while limiting potential exposure to COVID-19. In an effort to accomplish this, effective for services beginning on March 6, 2020, the waiver removes geographic limitations related to the location of Medicare beneficiaries and authorizes Medicare to pay for visits furnished to its beneficiaries via telehealth while the beneficiary is in their home. The waiver does not amend those authorized to provide telehealth services, and these services must be provided by an audio and video telecommunications system that accommodates real-time, live communication between the provider and the beneficiary. Additionally, CMS has noted that there will flexibility regarding requirements related to provider relationships, cost-sharing, and the Health Insurance Portability and Accountability Act (“HIPAA”).
On March 19, 2020, the Mississippi Division of Medicaid announced that it will expand telehealth services for Medicaid beneficiaries effective immediately through April 30, 2020. According to Medicaid’s press release and State Plan Amendment (“SPA”) 20-0010 Telehealth Emergency Waiver, the waiver will allow Medicaid beneficiaries to obtain telehealth services from his or her home through the use of their own telephonic landline in addition to their cell phone, computer, tablet, or other device with a camer. The requirement that a telepresenter be present is likewise waived. Further, Telehealth services have been expanded to allow the use of telephonic audio that does not include video.
On March 14, 2020, the Mississippi Board of Medical Licensure issued a proclamation urging all physicians to utilize telemedicine in an effort to limit potential risks to patients and to avoid unnecessary patient travel. To accommodate this, during the declared state of emergency, the Board held that it will not take any enforcement action against a physician related to the personal examination of a patient prior to prescribing or ordering administration of any medication—to include controlled substances. During this time, the Prescription Monitoring Program must still be utilized by physicians; however, urine drug screens are not required.
Further, the Board proclaimed that an “out-of-state” physician, holding an unrestricted license to practice medicine in another state, is authorized to practice telemedicine in Mississippi during the declared state of emergency. In addition to holding an unrestricted license, the “out-of-state” physician must inform the Board that he or she is not subject to any disciplinary or investigatory proceeding.
In response to the declared state of emergency and the Mississippi Board of Medical Licensure Proclamation referenced above, on March 16, 2020 the Mississippi Department of Insurance issued Bulletin 2020-1 “Insurance Coverage Regarding the Use of Telemedicine During the COVID-19 Crisis”. This Bulletin directed insurers to adopt policies that would encourage their policy holders to utilize telemedicine in an effort to fight the community spreading of COVID-19. To facilitate this, the Commissioner of Insurance, Mike Chaney, temporarily suspended certain limitations on the provisions of telehealth services. Notably, the Bulletin suspended the prohibition on audio-only telephones, any limitations of coverage to only “network” telehealth providers, and any limitations of telehealth coverage to provider consultation only. The Commissioner specifically noted that mental health services should be covered by telemedicine in the same manner they would be covered if provided in an in-person setting.