CMS Rolls Out a General Provider Telehealth and Telemedicine Tool Kit
Susan L. St. John, Esq.
![Susan L. St. John, Esq.]()
Susan L. St. John, Esq.
Medicare Auditor turned Attorney at Garfunkel Wild, P.C. | DME Law | Home Health | LLM in Tax | Health Law | Mergers & Acquisitions | Business Transactions
By: Susan St. John
CMS has rolled out a telehealth/telemedicine tool kit to assist medical professionals with health care delivery during the current COVID-19 public health emergency.
The toolkit contains information and links concerning:
- 1135 Waivers – allows the Secretary of HHS to temporarily waive or modify certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements to ensure sufficient health care services and items are available to meet the needs of individuals enrolled in Social Security Act programs during the emergency and that providers who provide services in good faith can be reimbursed and exempted from sanctions (provided there is no determination of fraud and abuse). 1135 waiver or modifications include:
- Conditions of participation and other certification requirements;
- Program participation and similar requirements;
- Preapproval requirements;
- State licensing requirements where services are rendered as long as the provider has equivalent licensing in another State (for Medicare, Medicaid, CHIP reimbursement only; State licensing still controls whether a non-Federal provider may provide services in a state he/she is not licensed in);
- EMTALA sanctions for redirection for medical screening, as long as redirection is not the result of discrimination on the basis of a patient’s source of payment or ability to pay;
- Stark self-referral sanctions;
- Adjustment (not waiver) to performance deadlines and timetables;
- Limitations on payment to permit Medicare enrollees to use out of network providers in an emergency situation.
This is just a summary of the types of virtual services that may be provided. To understand providing virtual services more fully, the following link is informative.
- The telehealth/telemedicine expansion pursuant to 1135 Waiver for COVID-19 allows for providers to bill for and receive reimbursement for services provided via the expanded telehealth/telemedicine services.
- Providers should refer to the most recent press releases for additional authority and clarification of telehealth/telemedicine expansion during the COVID-19 public health emergency. Press releases and announcements can be found here and here.
- President Trump has also rolled out checklists and tools to accelerate relief for State Medicaid and CHIP Programs.
- Embedded in the links provided herein are additional links to assist providers in navigating the “new normal” when it comes to health care access and delivery during COVID-19.