Call to Action: Restrictions Around Virtual Health Can’t Go Back to “Normal”

David Cohen, Chief Product and Technology Officer, Greenway Health As a result of the COVID-19 pandemic, the federal government has passed several stimulus packages with the goal of helping employers keep their business in operation while office volume is down and, in some cases, practices are physically closed. The CARES Act , which included the Paycheck Protection Program (PPP) and Provider Relief Fund , for example, has provided some relief to eligible healthcare providers, including low-interest rate loans to help providers pay staff salaries, rent, and other overhead expenses.  

While support from the federal government has helped many practices and healthcare systems, this short-term solution to what the CDC predicts could be a long-term challenge is not enough to keep many providers’ doors open. Providers need innovative tools and technology, such as telehealth and remote patient monitoring (RPM), and stronger care coordination to meet patients where they are today: at home. 

During COVID-19 and Beyond: Telehealth Goes Mainstream 

At the very start of the COVID-19 pandemic, the act of virtually practicing medicine became the go-to method overnight. And it is clear that virtual care will not go away any time soon.

Prior to the pandemic, despite known value to improving cost, quality, and access, telehealth was underutilized for various reasons, including licensure, reimbursement, and eligible services. Fortunately, CMS has since broadened access to Medicare telehealth services in an effort to increase access and availability to individuals across the U.S. The changes allow for telehealth visits to be considered, billed, and paid at the same rate as in-person visits. 

As a result, patients and providers alike have quickly become accustomed to virtual appointments. In fact, Forrester Research analysts predict that virtual health visits will top 1 billion this year alone , and telehealth adoption continues to increase each month. 

But it’s important for providers to recognize the three primary areas of telemedicine that can be utilized — e-visits, virtual check-ins, and telehealth appointments – as each type serves a specific function within the overall act of practicing medicine virtually, and billing requirements for each varies. CMS serves as a valuable resource for providers unsure of current coding requirements for these appointments. 

It’s also important to note that CMS has also expanded and streamlined its Accelerated and Advance Payments Program to provide conditional partial payments to providers and suppliers to address disruptions in claims submission and/or claims processing subject to applicable safeguards for fraud, waste, and abuse. 

Despite federal restrictions around telehealth loosening during the early stages of the COVID-19 outbreak in the U.S., many of the loosened regulations are only temporary. It is unclear...