HITEQ Center / Wednesday, April 22, 2020 / Categories: Privacy and Security, Privacy & Security Best Practices, HIPAA, Telehealth, Telehealth Resource Centers Telehealth Policy during Coronavirus/ COVID-19 Pandemic Updated 11/16/2020 with NIST Guidance on Securing the Telehealth Remote Monitoring Ecosystem We are adding additional telehealth information, including policy and regulatory developments, relevant to coronavirus/ COVID-19 pandemic as it impacts health centers as it becomes available. Please see the resource links below. Physicians and Other Clinicians: CMS Flexibilities to Fight COVID-19 Published by the Center for Medicare and Medicaid Services in May 2021. CMS Loosens Restrictions on RHC and FQHC Telemedicine Services – COVID-19 Updates Published by BKD on April 10, 2020. Key Information: Coding and regulatory requirements for implementing telehealth in accordance with CMS's loosened restrictions. Effective March 27, 2020, the CARES Act removed restrictions in place prior to the COVID-19 emergency, and now allows FQHCs to serve as distant site providers for telehealth audiovisual (but not audio-only or telephone) visits, and these can be rendered to new or established patients. CMS also added 80 codes to the existing list of eligible telehealth (audiovisual) services. Telehealth Coverage Policies In The Time Of COVID-19 to Date Published by the Center for Connected Health Policy, updated regularly in March and April 2020. Key Information: Telehealth waivers under Medicare and Medicaid are in place, as well as DEA actions permitting prescriptions for controlled substances via telemedicine. Scroll to the bottom of the page for FQHC specific information. Commercial Payers – Expansion of Telehealth Services for Behavioral Health Published by National Council for Behavioral Health on April 10, 2020. Key information: Quick reference guide for changes in telehealth policies, allowable services and billing guidance across commercial payers. COVID-19 Telehealth Guide: Virtual Check-ins, VCS, e-Visits & RPM Guide by Certinell, with regular updates to federal and state policy. March and April 2020. Key information: Code Summary Covered in COVID-19 (Coronavirus Disease 2019) Special Report: COVID-19 diagnostic tests: HCPCS codes U0001 and U0002 Virtual Check-Ins: HCPCS code G2012 (communication technology-based services) and HCPCS code G2010 (remote evaluation services) Virtual Communication Services (VCS): HCPCS code G0071 e-Visits: CPT codes 99421-99423 Remote Patient Monitoring (RPM): CPT codes 99457 and, new for 2020, 9945 Notification of Enforcement Discretion for telehealth remote communications during the COVID-19 nationwide public health emergency Published by HHS Office of Civil Rights (OCR) on March, 17 2020. Key Information: This notice from HHS OCR states penalties won’t be assess on providers who use non-HIPAA compliant communication technology to provide telehealth services during COVID-19 public health emergency. This applies to all healthcare services, not only those related to COVID-19. Additional related comments from CMS can be seen here. HITEQ created this issue brief that provides easy reference and straightforward "Do and Don't" guidance based on this OCR notice. Telehealth and Telephone Visits in the Time of COVID-19: Sample FQHC Workflows Published by the Center for Care Innovations, March 24, 2020. Key Information: Many health centers and safety net clinics are switching their scheduled in-person visits to telephone or video visits, this resource provides some sample workflows and guidance for how clinics are making this transition, including examples from eClinicalWorks, NextGen, and OCHIN Epic. An appointment rescheduling flowsheet from a health clinic is available from NEMJ. COVID-19 Public Health Emergency Response and 42 CFR Part 2 Guidance Published by the Substance Abuse and Mental Health Services Administration (SAMHSA) on March 19, 2020. Key Information: There has been an increased need for telehealth services, and in some areas without adequate telehealth technology, providers are offering telephonic consultations to patients. In such instances, providers may not be able to obtain written patient consent for disclosure of substance use disorder records. The prohibitions on use and disclosure of patient identifying information under 42 C.F.R. Part 2 would not apply in these situations to the extent that, as determined by the provider(s), a medical emergency exists. State Data and Policy Actions to Address Coronavirus Published and updated March and April 2020 by Kaiser Family Foundation. Key information: This site is tracking state-by-state policy actions such as state waivers of cost sharing for COVID-19 testing, state waivers of prior authorization requirements, early perscription refills, and expanded marketplace insurance enrollment. Other important sources of state information are Medicaid Federal Disaster Resources which includes details on each state’s 1135 Waiver as approved by CMS and the Center for Connected Health Policy's tracking of COVID-19 related state actions. Resource Links New Healthcare Cybersecurity Guide Available, NIST SP 1800-30, Securing Telehealth Remote Patient Monitoring EcosystemThe NCCoE performed a risk assessment on the telehealth RPM ecosystem, leveraging the NIST Cybersecurity Framework, NIST Privacy Framework, and other relevant guidance to develop a reference architecture. The reference architecture demonstrates how HDOs may use standards-based approaches and commercially available cybersecurity technologies to implement privacy and cybersecurity controls enhancing the resiliency of the telehealth RPM ecosystem. Print 41274 Tags: telehealth telemedicine Office of Civil Rights 42 CFR Part 2 COVID-19 Related Resources Bridging the Digital Divide Electronic Patient Engagement Tools: Adaptation for Use in COVID-19 Vaccination Rollout COVID-19 Vaccine Communication: Electronic Patient Engagement Vendor Discussion COVID-19 Vaccine Communication: Electronic Patient Engagement Vendor Discussion COVID-19 Vaccine Communication: Electronic Patient Engagement Vendor Discussion
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