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CMS Expands Medicare Telehealth Benefits During COVID-19 Public Health Emergency

CMS announced that it will immediately expand telehealth coverage for Medicare beneficiaries nationwide to help limit risk of exposure and spread of the COVID-19 virus. CMS is expanding this benefit on a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act.

Effective March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for professional services furnished to beneficiaries in all areas of the country in all settings, including their homes. Medicare is suspending its existing requirement that telehealth services only be furnished when the patient is in a qualified "originating site," such as a healthcare facility or rural area for the duration of the public health emergency. The Medicare coinsurance and deductible would generally apply to these services. However, HHS is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs. To the extent the 1135 waiver requires an established relationship, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public health emergency.

Additionally, HHS will waive penalties for HIPAA violations against providers that serve patients in good faith through everyday communications technologies, such as FaceTime or Skype, during the COVID-19 nationwide public health emergency.  For more information: www.hhs.gov/hipaa/for-professionals/special-topics/....

  • To read the Fact Sheet on this announcement visit here.
  • To read the Frequently Asked Questions on this announcement visit here.

This guidance, and earlier CMS actions in response to the COVID-19 virus, are part of the ongoing White House Task Force efforts. To keep up with the work the Task Force is doing in response to COVID-19 click here www.coronavirus.gov. For information specific to CMS, please visit the Current Emergencies Website.

For information on telehealth claims please review this CMS MLN article.

If you have additional questions, please contact Jillian Winans, regulatory affairs specialist at jwinans@ascrs.org

Introduction to Tele-Ophthalmology Guide

In response to the increased use of telemedicine and its impact on the delivery of ophthalmic services, the ASCRS ASOA Telemedicine Task Force created the guide, “Introduction to Tele-Ophthalmology,” as an educational resource for physicians and administrators to learn about teleophthalmology. ASCRS ASOA members have exclusive access to this guide, designed to educate readers on the benefits of tele-ophthalmology, various delivery methods, reimbursement, potential liabilities, and challenges.

ASCRS ASOA Teleophthalmology Guide

Tele-Ophthalmology in Your Practice Webinar

Now available is a recording of the January 30, 2019 webinar, “Tele-Ophthalmology in Your Practice,” featuring Ranya Habash, MD, assistant professor of clinical ophthalmology at the Bascom Palmer Eye Institute, who provides a comprehensive introduction to tele-ophthalmology, that explores the benefits of teleophthalmology, various delivery methods, Medicare and private payer reimbursement, licensing, and liability considerations. Dr. Habash, an early adopter of telemedicine, has developed an app for secure messaging and video conferencing designed for easy adoption of telemedicine among healthcare professionals. In addition, she consults with healthcare and technology companies seeking to develop and deploy telemedicine tools. Stephen D. Klyce, PhD, FARVO, chair of the ASCRS ASOA Telemedicine Task Force is the moderator of the webinar.

Watch Webinar

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