And even when regulations are temporarily lifted to facilitate telemedicine, health systems and patients will have their own challenges in implementing and accessing these services. This may involve providing direct funding for health systems and smaller practices to implement telemedicine. Urgent Care Center Network Get the care you need when you need it at an urgent care center in our network–no appointment needed. Policy Changes in Response to COVID-19: In response to the COVID-19 outbreak, CMS issued guidance reiterating states can use existing flexibility to provide coverage for telehealth services: “States have broad flexibility to cover telehealth through Medicaid, including the methods of communication (such as telephonic, video technology commonly available on smart phones and other devices) to use.” They clarify, “No federal approval is needed for state Medicaid programs to reimburse providers for telehealth services in the same manner or at the same rate that states pay for face-to-face services.” The FAQ guidance also discusses how telehealth and telephonic services can be covered for FQHCs and rural health centers (RHCs) and under managed care contracts, if states choose to do so. Published: May 11, 2020. home was not an eligible “originating site”), limiting telemedicine’s reach for many low income people. “FCH was built on the promise that a provider-centric model is a better alternative to the fragmented care delivery approach of large national insurers,” said Clyde Walker, First Choice Health board chair, in a statement. CDC links for more information: 1. Potential concerns to this approach include the possibility that protected health information (PHI) that is discussed or sent over a non-HIPAA compliant platform may be accessed, shared or even sold by these platforms. Organizations. Whether it be doctors, advance practice clinicians like nurse practitioners and physicians’ assistants, or registered nurses who facilitate telemedicine interactions, all will need to be trained on telemedicine technologies, requiring additional time and resources. This limits telehealth’s reach for Medicare beneficiaries without access to smartphones or other video communications. For FirstHealth On the Go, download the app on your Android or Apple device or get st… These plans may cover telemedicine, but each plan can choose to cover these services or not. The waiver does the following: lifts the requirement that beneficiaries must live in rural areas in order to receive telehealth services, meaning beneficiaries in any geographic area could receive telehealth services; allows the patient’s home to qualify as an “originating site” from which they can access telehealth visits; allows telehealth visits to be delivered via smartphone with real-time audio/video interactive capabilities in lieu of other equipment; and removes the requirement that providers of telehealth services have treated the beneficiary in the last three years. And don’t miss these top workplace benefit stories from EBN’s editorial team. States are also using 1915(c) Appendix K waivers to enable the provision of home and community-based services (HCBS) remotely by telehealth for people with disabilities and/or long-term care needs. Opens in a new window. Changes to Medicare Advantage: Medicare Advantage plans have been able to offer additional telehealth benefits not covered by traditional Medicare and have flexibility to waive certain requirements with regard to coverage and cost sharing in cases of disaster or emergency, such as the COVID-19 outbreak. Nine states require special licenses specific to telemedicine. Direct Care Providers. In the months leading up to quarantine, First Choice partnered with companies like 98point6 — an on-demand primary care service — and Rightway Health, a service that advises consumers on the best place to seek medical attention. The Seattle-based healthcare company connects self-insured employers across the country with providers in … Coronavirus testing codes follow: 1. They also offer telemedicine programs that address behavioral health, weight loss and substance abuse. At a time when many people in the U.S. are under shelter in place orders, this approach to care allows patients to maintain social distancing, reduce their risk of exposure to the novel coronavirus and potentially avoid overburdening emergency departments and urgent care centers at this time. Changes to Traditional Medicare: Based on new waiver authority included in the Coronavirus Preparedness and Response Supplemental Appropriations Act (and amended by the CARES Act), the HHS Secretary has waived certain restrictions on Medicare coverage of telehealth services for traditional fee-for-service (FFS) Medicare beneficiaries during the coronavirus public health emergency (first issued on January 31, 2020, and renewed on April 21, 2020). high startup costs, workflow reconfiguration, clinician buy-in, patient interest). The federal government regulates reimbursement and coverage of telemedicine for Medicare and self-insured plans, while Medicaid and fully-insured private plans are largely regulated on a state-by-state basis (Figure 3). The federal government, some states, and some health insurance carriers are trying to enable more telemedicine visits to be permitted and paid for. Importantly, most states are newly allowing both FFS and managed care Medicaid beneficiaries to access services from their home, and most are directing Medicaid plans to allow for reimbursement for some telephone evaluations. To make an appointment to virtually see one of our providers using the app, call: 860-528-1359. Your healthcare provider can contact you over the phone or the computer while you continue to practice social distancing. In a 2019 study by Definitive Healthcare, many outpatient practices reported not investing in telehealth due to these financial barriers. While these unprecedented and swift measures have been taken to broaden telemedicine access during this pandemic, gaps in coverage and access to telemedicine remain. Okigwe also anticipates a greater focus on providing more direct-to-employer health services. States, health systems, and insurance carriers have also moved with unprecedented speed to shift many visits that were previously done in person to a telemedicine platform. In response to the COVID-19 emergency to make telemedicine more widely available, the federal government has taken action in all these domains. For purposes of Medicaid, telemedicine seeks to improve a patient's health by permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site. However, this may not translate to widespread use of telehealth among older adults, particularly when Medicare’s expansion of telehealth services for people in traditional Medicare is at the moment limited to the duration of the public health emergency. AK, AZ, AR, DE, HI, IA, KS, KY, LA, MD, MS, MT, OH, OK, SD). phone) to qualify for coverage. Medicare is also temporarily expanding the types of providers who may provide telehealth services. With expanding use of telemedicine in clinical settings, health systems need to decide which providers they will divert to phone lines and/or video visits and how to manage their patient flow, while still ensuring enough staff to manage in-person care. Almost all states are issuing emergency policies in response to the COVID-19 outbreak to make telehealth services more widely available in their Medicaid FFS programs and/or through Medicaid managed care plans. However, to address COVID-19, out of state clinicians may be needed to conduct virtual visits with patients in states with the highest burden of cases. Telehealth Visits – As of March 6, 2020 First Choice VIP Care Plus has expanded telehealth in compliance with new CMS guidance, to include coverage in all areas (not just rural), in all settings, the use of popular video chat applications, and the increase of allowed services. It remains unclear if the U.S. will sustain this expanded use of telemedicine after the state of emergency ends, and to what extent low-income patients and patients with limited experience with or access to technology will be able to access these services. The telemedicine landscape is complex, with many moving pieces as different players respond to COVID-19. FCPP is a non-profit medical foundation committed to serving the health care needs of … As the COVID-19 pandemic evolves, so too are the emergency policies regarding telemedicine. Many insurers are reducing or eliminating cost sharing for telemedicine, for a limited period of time. In a March 2020 Interim Final Rule, CMS stated that it would allow providers to “evaluate beneficiaries who have audio phones only.” In a subsequent announcement, CMS broadened this to include behavioral health services and patient education services, but still not the full range of telehealth services that can be provided using two-way audio-video connection. This program currently awards a total of $8.7 million a year for telehealth technologies used in rural areas and medically underserved areas. January 12, 2021 – The growth of telehealth has exploded since the COVID-19 pandemic began, and there are no signs of it slowing down anytime soon, panelists agreed at CES 2021. Patients. One survey projects a possible 5.3% increase in health plan costs for large employers in 2021. First Choice Health Covers the Cost of Telehealth and Virtual Care Services for Employers via 98point6 Amid COVID-19 Crisis PR Newswire • March 25, … “We were getting double digit increases every year, but by becoming self-funded we were able to take control of our plan,” said Mark Deven, city manager of Arvada, in a previous report. There are some inherent differences to evaluating patients remotely from their homes compared to in-person. That has an impact on cost for people and their employers,” Okigwe said in a previous report. This requires significant financial and workforce investment, which may be more difficult for smaller or less-resourced practices. Before the onset of the COVID-19 pandemic, utilization of telemedicine in the U.S. was minimal. Next, we outline what changes have been made to telehealth policy and implementation by the federal government, state governments, commercial insurers and health systems in response to the COVID-19 emergency, as well as what gaps remain. For patients who are now turning to telemedicine visits rather than their usual source of in-person care, clinicians in some states may face legal barriers to online prescribing medications if they do not already have a pre-existing relationship with the patient. Our Rising Star Awards nomination deadline has been extended. HHS has waived enforcement of HIPAA for telemedicine, while the DEA has loosened requirements on e-prescribing of controlled substances. As health systems and smaller practices implement or ramp up use of telemedicine in response to this crisis, there are many provider facing and patient facing considerations to address. In response to COVID-19, some state Medicaid programs that would normally require written consent have waived this requirement; for example, providers caring for Medicaid beneficiaries in Alabama, Delaware, Georgia, and Maine can now obtain verbal consent for telemedicine, rather than having the patient sign a written consent form. Telehealth billing guidelines for members of First Choice Health Administrators: In order for services to be considered as Telehealth, they must be billed with either Telehealth modifier 95 for CPT codes in appendix P of the AMA CPT Book, or modifier GQ/GT for HCPCS codes in the CMS Telehealth Code List for 2020, or Place of Service 02. HIPAA), federal prescribing laws for controlled substances, grant funding for telehealth initiatives and Medicare coverage of telehealth. Figure 5: Key Changes to Coverage Restrictions for Medicare Fee-for-Service During the COVID-19 Emergency. home) and modalities (e.g. The deal makes 98point6’s telehealth platform available to self-funded employers utilizing First Choice’s health network, allowing covered employees to access on-demand primary care services ― such as consultation, diagnosis and treatment ― via their phones. Others participate in “compacts” that allow providers in participating states an expedited process to practice in other compact states. For some plans this applies only to telehealth visits related to COVID-19, while for others this applies to any health indication. A significant portion of telehealth policy is decided by state governments. Telemedicine allows health care professionals to evaluate, diagnose and treat patients at a distance using technology. This complexity in the regulatory framework for telemedicine creates challenges for patients in knowing what services are covered, and for providers in knowing what regulations to abide by. Read more: First Choice prioritizes accessibility through telehealth benefits, “If you’re able to seek and get care when you need it, you’re likely going to be healthier. A separate provision in the CARES Act allows federally qualified health centers (FQHCs) and rural health clinics (RHCs) to serve as “distant site” providers, and provide telehealth services to Medicare beneficiaries during the COVID-19 emergency period (Figure 5). As clinicians seek new ways to serve patients and stem the rapid spread of the novel coronavirus in the United States, policymakers and insurers have looked to telemedicine or telehealth to provide care to patients in their homes. The Seattle-based healthcare company connects self-insured employers across the country with providers in their area. A number of gaps remain in ensuring access to telemedicine during the COVID-19 pandemic. Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California. This means some telemedicine platforms may need to hire more clinicians in order to keep up with demand. Avenues to consider to further expand telemedicine access include: There are potential trade-offs in loosening regulations on telemedicine, including privacy issues and quality of care. With the continued spread of the coronavirus that causes COVID-19, FirstHealth is committed to providing telemedicine options that allow providers to give people the care they need from the comfort and safety of their own home. The act strikes the current funds, and replaces it with $29 million for five years, starting in 2021. Contact. For example, if a clinician is located in California, but is providing services remotely to a patient in Oregon via telemedicine, the provider must be licensed in Oregon, the state where the patient is located. Additionally, a study by the Harvard School of Public Health showed that 21% of rural Americans reported access to high-speed internet is a problem for them or their family. Implementing new telemedicine initiatives in response to COVID-19 oftentimes requires a redesign of longstanding clinical care models. First Choice SafeLink Phone Program First Choice by Select Health of South Carolina is proud to be working with SafeLink Wireless (PDF) to offer the Lifeline program at no cost to you! Prior analysis shows that the majority of large employer plans, including those that are self-insured, cover some telemedicine services. Similarly, utilization of telemedicine by traditional Medicare and Medicaid and beneficiaries enrolled in managed care plans had been trending upward, but remained low. With growing demand for telemedicine, several changes have been made to telehealth policy, coverage and implementation, in order to make telemedicine more widely accessible during this state of emergency. On a state level, many state governments have focused on expanding telehealth in their Medicaid programs, as well relaxing state-level restrictions around provider licensing, online prescribing and written consent. In contrast to fully-insured health plans which must comply with both federal and state requirements, self-insured health plans are regulated by the federal government through the Department of Labor. If you are preparing for an upcoming virtual visit, download tips are listed below: 1. While many of the telemedicine regulations have been temporarily relaxed, for telemedicine to be more broadly accessible to patients in the U.S. over the long term, several actions would need to happen (Figure 4). First Choice providers are now using telemedicine to evaluate and treat patients. If a patient needed to buy home monitoring equipment like a blood pressure cuff or a glucose monitor, it remains unclear if this would be paid for by the patient out of pocket, or by the health system. Alina Salganicoff Follow @a_salganicoff on Twitter Evaluating and Reporting Pers… Serving local communities since 2015. However, the HHS Office of Inspector General is providing flexibility for providers to reduce or waive cost sharing for telehealth visits during the COVID-19 public health emergency. A study of Medicaid claims data showed beneficiaries enrolled in Medicaid managed care plans were more likely than those in FFS programs to use telemedicine. , and Figure 3: Who Regulates Telemedicine in Health Plans? However, taking important vital signs like a temperature and oxygen saturation proves challenging, particularly if the patient does not have a thermometer or pulse oximeter at home. How benefits bosses at Zynga, Meredith, the Nashville Public Schools system and the city of Azusa, California, redefined their work perks and offerings during the new coronavirus era, Noodles & Co increased employee retention, financial wellness with on-demand pay, Addicted: How employers are confronting the U.S. opioid crisis, Why COVID is making fertility benefits more popular, Americans are blowing the whistle on their employers like never before, Culture, transparency decided Glassdoor’s ‘Best Places to Work’ winners, Employers can help employees save for college with Goodly 529 plans, Best of the week: The top trends and news from the benefits space, 5 programs making workplaces more inclusive. Telemedicine, what was once a niche model of health care delivery, is now breaking into the mainstream in response to the COVID-19 crisis. For those wishing to initiate a telemedicine program before the COVID-19 emergency, significant financial and personnel investment was typically required. Employers including Walt Disney Company and Costco cinched the 51-100 spots on Glassdoor’s annual “Best Places to Work” awards. “We believe the future of healthcare is in minimizing the friction between a patient and provider,” Okigwe said in a release. Through our telehealth services vendor, Community gives you 24/7/365 access to quality medical care via video and telephone consultations. Separate from the time-limited expanded availability of telehealth visits, traditional Medicare also covers brief, “virtual check-ins” via telephone or captured video image, and E-visits, for all beneficiaries. Importantly, these expanded telehealth services under Medicare are not limited to COVID-19 related services, rather they are available to patients regardless of diagnosis and can be used for regular office visits, mental health counseling, and preventive health screenings. When not mandated by the state, private insurers are free to decide which telehealth services their plans will cover. Employee Benefit News. In response to the unprecedented pressure to expand services and control the transmission of the novel coronavirus, the federal government, many states governments and commercial insurers are expanding coverage of telemedicine and relaxing existing regulations. Historically, states have had broad flexibility to determine whether to cover telehealth/telemedicine, which services to cover, geographic regions telehealth may be used, and how to reimburse providers for these services. The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 If your doctor provides phone or video appointments, follow their instructions. A KFF study showed that in 2017, sizable shares of non-elderly adults with Medicaid reported they had never used a computer (26%), did not use the internet (25%) and did not use email (40%). 2021 - First Choice Health FCH Providers portal provides access to benefits and eligibility, status of claims and payments, payor search, provider update form, and more. Many hospitals have instructed patients with suspected coronavirus symptoms or exposure to call their doctors or turn to telemedicine first, before showing up to the emergency room or urgent care visit. Newsletter. As of Fall 2019, 41 states and D.C. had laws governing reimbursement for telemedicine services in fully-insured private plans, but private insurer laws enacted by states vary widely. Telemedicine Capability. Additionally, Medicaid programs in 46 states and DC have issued guidance to expand coverage or access to telehealth during this crisis, while 38 states and DC have granted payment parity for at least some telehealth services as of May 5, 2020. Learn more about the First Choice SafeLink phone program El Programa de SafeLink de First Choice This guidance, however, is voluntary and plans will vary in their responses to this new flexibility. The Cleveland Clinic, University of Washington (UW), NYU Langone, Oregon Health Sciences University (OHSU), Intermountain Health Care, Medical University of South Carolina (MUSC), and Rush University Medical Center are all advising patients with suspected coronavirus to start by using a virtual visit or online screening, rather than presenting to an emergency room for testing. Normally, clinicians must be licensed to practice in states where they offer telemedicine services, and states regulate which health professionals are credentialed to practice in their state. The National Consortium of Telehealth Resource Centers (NCTRC) currently urges health centers to sign a Business Associate Agreement (BAA) with their chosen platform, to agree that the data exchanged are safeguarded. Access to telemedicine may be particularly challenging for low-income patients and patients in rural areas, who may not have reliable access to internet through smartphones or computers. In the U.S., existing telemedicine platforms like Amwell and UPMC’s virtual urgent care have reported rapid increases in their utilization. In 2020, the company expanded coverage to include more than 55,000 new members across the country. Minutes for treatment of non-emergency, everyday healthcare issues and feel better fast of slow growth telemedicine! 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