As part of its response to the coronavirus pandemic, the federal government is broadly expanding coverage of Medicare telehealth services to beneficiaries and relaxing HIPAA enforcement. This will give doctors the ability to provide more services to patients remotely. 

Medicare covers telehealth services that include office visits, psychotherapy, and consultations provided by an eligible provider who isn’t at your location using an interactive two-way telecommunications system (like real-time audio and video). Normally, these services are available only in rural areas, under certain conditions, and only if you’re located at one of these places:

  • A doctor’s office
  • A hospital
  • A critical access hospital (CAH)
  • A rural health clinic 
  • A federally qualified health center
  • A hospital-based dialysis facility
  • A skilled nursing facility
  • A community mental health center

Under the new expansion, Medicare will now pay for office, hospital, and other visits provided via telehealth in the patient’s home. Doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers will all be able to offer a variety of telehealth services to their patients, including evaluation and management visits, mental health counseling, and preventive health screenings. In addition, relaxed HIPAA enforcement (the law governing patient privacy) means doctors may use technologies like Skype and Facetime to talk to patients as well as using the phone. 

In addition to Medicare’s expansion, states are also allowing doctors to provide telehealth services to Medicaid beneficiaries. In Pennsylvania, the Department of Human Services (DHS) has issued guidance to Medicaid-enrolled providers and managed care organizations that encourages the use of telemedicine as a way of mitigating the spread of COVID-19 through reduced person-to-person contact between health professionals and Physical HealthChoices members and fee-for-service beneficiaries, particularly those who are in quarantine or isolation as a result of possible COVID-19 exposure.

“Under rapidly changing circumstances, DHS is acting quickly to accommodate the needs of our Medicaid-enrolled providers who are on the front lines of this crisis,” DHS Secretary Teresa Miller said. “The use of telemedicine is a common-sense example of the flexibility this situation demands. DHS will continue to work together with our Medicaid providers, managed care organizations and partners across all program offices to effectively and safely confront this challenge while continuing to provide services to the millions of Pennsylvanians who depend on us.”

Telemedicine is two-way, real-time interactive communication between the patient and the doctor or other practitioner. The Office of Medical Assistance Programs (OMAP) has supported the use of telemedicine under certain circumstances since 2012. OMAP’s most recent guidance establishes a preference for the use of telemedicine as a delivery method for medically necessary healthcare services when the patient is quarantined or self-isolated due to exposure or possible risk of exposure to the COVID-19 virus. Telemedicine can be delivered through audio-video conferencing hosted by a secure mobile application. During this state of emergency, telephone-only services may be utilized in situations where video technology is not available.

This expansion of telehealth services will allow older adults who are particularly vulnerable to COVID-19 to stay home and still get medical advice. If you need to see a medical provider during this health emergency, check to see whether they are employing telehealth services. To use telehealth services, you need to verbally consent and your doctor must document that consent in your medical record.