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COVID-19 and the Complexities of Telehealth Privileging (Part 2)

By Joe Morris, Writer, HealthStream

This blog post is based off of an Industry Insight Webinar: Disaster and Telehealth Privileging During the COVID-19 National Emergency.

Telehealth gains prominence as restrictions are loosened

Another major shift in care delivery has been the skyrocketing use of existing telehealth operations and deployment of new or expanded ones. Already seen as an efficient, cost-effective way to enhance care, telehealth now can be close the physical gap between providers and patients who may be nearby but cannot leave home.

The National Emergency declaration provides some good news.

HIPAA guidelines have been relaxed for this national emergency.  HHS has announced that it will exercise “enforcement discretion” and will not impose penalties for noncompliance with regulatory requirements during the “good faith provision of telehealth” services during the COVID-19 national emergency.

Telehealth regulations around billing for Medicare for Medicare services to Medicare patients have been waived under Section 1135 of the Social Security Act, and the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 provided for $500 million in telehealth reimbursements.

The challenge will be not just to stand up a telehealth service, but also explore how changed and relaxed rules affect service delivery — and who can provide services, another element of a changed credentialing and licensure landscape.

“The telemedicine regulations are state specific,” says Todd Sagin, President and National Medical Director, Sagin HealthCare Consulting. “They vary a great deal. Common practice is a provider must be licensed in the state where that patient resides. CMS has waived this requirement for Medicare patients and many states have waived it for Medicaid patients and in numerous states this requirement has been waived for all patients.”

“There is a definite need for a certain tolerance for uncertainty in this time,” he says, noting that all the issues and concerns are not being addressed at the same time as people struggle to quickly cope with this crisis. But to refer to an old adage, now’s the time to document, document, document.

“If you're going to take latitude and liberties in this time of crisis, keep some documentation on what you are doing,” he advises “If you are authorizing someone to provide telemedicine services, make sure you capture the dates and the circumstances. If you're granting temporary privileges, make sure you document what you're doing as you would with any grant of temporary privileges. As long as you can indicate that you've taken a specific action with intent in order to accommodate the exigencies of this crisis, you'll be in a much better position afterward if anybody asks what the justification was for the actions you took.”

Learn more about how VerityStream provides Credentialing, Privileging, Enrollment, and Evaluation for Health Systems and Health Plans.


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