Situation:  During the public health emergency (PHE), telemedicine was used as a way to allow for needed medical care to be provided without the need for in-person interactions that would put patients and healthcare providers at risk of COVID transmission. To allow for more use of telemedicine during the PHE, telemedicine rules/ requirements that precluded certain in-person interactions had to be addressed.  They were addressed mainly by waivers from Medicare, the Office of Civil Rights (OCR), and the Drug Enforcement Agency (DEA).

Medicare

• Waived audio-video requirements for many telehealth services.
• Permitted telehealth services regardless of the geographic location of a patient and their provider.
• Expanded the list of healthcare professionals who were permitted to provide telehealth services.

OCR

• Enacted enforcement discretion for imposing penalties for HIPAA violations related to the good-faith provision of telehealth services.

DEA

• Temporarily removed the in-person medical evaluation required prior to prescribing controlled substances.

Issue:  The last day of the PHE is May 11, 2023. Some of the telehealth waivers will end, some will remain, and some will remain for a temporary period. What should a provider do?

Solution:  As soon as you can, implement the following steps.

1. Identify those services that you’ve been providing and billing under a waiver.
2. Determine which ones, if any, are extended (or not extended) post-PHE.
3. Transition the relevant services that are not extended away from telehealth.
4. Update your telehealth policies and procedures.
5. Educate staff on the changes.
6. Establish a point person to ensure changes are made timely.
7. Prepare a timely audit.