Editor’s notes: After receiving hundreds of waiver requests from healthcare providers, state governments and state hospital associations during the public health emergency, the Centers for Medicare & Medicaid Services (CMS) temporarily suspended a number of rules, allowing for more than 80 additional services to be furnished via telehealth through interactive apps with audio and video capabilities or audio phones only. These waivers include, but are not limited to, emergency department visits, initial nursing facility and discharge visits, remote patient monitoring services, home visits, and therapy services for both new and established patients.
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Explore This IssueApril 2020
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The CMS is also allowing physicians to supervise clinical staff using virtual technologies when appropriate, instead of requiring in-person presence. However, it should be noted that these changes are temporary and apply only for the duration of the national emergency declaration and that individual state regulations may still be in place. Check with your state medical board for up-to-date information, and review the Federation of State Medical Board’s current list of telehealth waivers by state.
Telemedicine has been around for more than 40 years. It started with physician consultations over the telephone and, due to advances in technology, has expanded significantly in how it is used by collaborating physicians and across practice areas to provide various types of treatment. According to the American Hospital Association, approximately 80% of hospitals use telehealth services in some capacity to reach patients.
Recent changes in state and federal laws have made telemedicine services more likely to be covered and reimbursed by insurance companies, benefitting both providers and patients. Now more than ever, patients have the opportunity to receive quick, affordable treatment in virtually any location. However, physicians should be aware that telemedicine coverage and reimbursement varies significantly by state.
Recent reforms have expanded the access and use of telemedicine, but the legal and regulatory framework has many layers and can create compliance hurdles.
What Is Telemedicine?
Telemedicine is the remote diagnosis and treatment of patients provided through the use of telecommunications technology. The most common communication channels for telemedicine include:
Store & forward: An asynchronous way to share patient medical information, such as lab reports, imaging, videos and other records. Twenty-nine states and Washington, D.C., cover store-and-forward telehealth services.
Remote patient monitoring (RPM): RPM allows healthcare professionals to track a patient’s vital signs and activities at a distance and over time. Twenty-two states and Washington, D.C., cover remote patient monitoring, but the type of condition covered varies by state. For example, Texas covers RPM services for cancer, asthma and hypertension, but Arizona covers RPM only for congestive heart failure.