On Jan. 31, 2020, then Department of Health & Human Services (HHS) Secretary Alex Azar issued the first public health emergency (PHE) in response to the emerging coronavirus pandemic. The PHE declaration triggered significant steps from the federal government to ramp up efforts to reduce the spread of the virus, as well as new flexibilities to help providers continue to care for their patients during a pandemic. The PHE declaration lasts 90 days and has been extended five times since January 2020. On April 15, Xavier Becerra, the newly confirmed HHS secretary, renewed the extension, effective April 21, 2021.
The Biden administration has said that its number one policy priority is addressing the coronavirus pandemic through greater vaccine production, distribution and education. The administration has indicated that the PHE will likely be extended through the end of the year.
Flexibilities Under the PHE
Following the first PHE declaration, many federal agencies issued new rules and policies that allowed for greater flexibilities to try to “flatten the curve” of increasing coronavirus cases.
The Centers for Medicare & Medicaid Services (CMS), recognizing the need for expanding telehealth during the pandemic, issued several telehealth-related flexibilities and waivers. In particular, it waived a number of requirements, including site-of-service requirements, issued flexibilities allowing providers to provide services across state lines and allowed providers to use everyday technology (such as Zoom) for telehealth visits. Following significant advocacy from many medical associations, including the ACR, CMS also reimagined reimbursement for telehealth visits during the pandemic. Under the PHE, audio-visual and audio-only telehealth visits are reimbursed at the same rate as an in-office visit.
Although these flexibilities will end when the PHE is rescinded, CMS recognizes that telehealth is here to stay. In the CY2021 Medicare Physician Fee Schedule, CMS outlined additions to the telehealth services list and the expanded use of virtual check-ins to allow for some audio-only telehealth visits. These new services will help expand the use of telehealth but will do so at lower reimbursement levels than the PHE reimbursement levels.
The ACR is actively engaged in advocacy efforts to expand the use and reimbursement of telehealth services beyond the current PHE and has many telehealth resources for providers.
Amanda Grimm Wiegrefe, MScHSRA, is the ACR’s director of regulatory affairs.
