In the current times I rest assured saying COVID-19 is creating a lot of chaos and confusion and is at the forefront of everyone’s minds. Medical providers are trying to determine ways to help patients without compromising public health, patient’s health and putting high risk patients at further risk. CMS has recognized this and enacted relief through 1135 Waiver.
What is the 1135 Waiver?
1135 Waiver Authority and Coronavirus Preparedness and Response Supplemental Appropriations Act –
- Enables Medicare patients to see any Medicare eligible provider by phone, video conference, email and patient portal.
- Allows Medicare patients to receive telehealth provider services that are related or not related to COVID-10 such as regular office visit, preventive health screenings and mental health counseling.
- Allows telehealth services to be provided in ALL settings, including the patient’s residence.
- Pays the provider the same rate as in office visits for E/M services
On March 17, 2020 the Office of Civil Rights made the following announcement:
“The Office for Civil Rights (OCR) at the U.S Department of Health and Human Services (HHS) announced, effective immediately, that it will exercise its enforcement discretion and will waive potential penalties for HIPAA violations against health care providers that serve patients through everyday communications technologies during the COVID-19 nationwide public health emergency.”
This announcement allows eligible providers to use applications such as, Facebook Messenger video chat, Skype, Apple Face Time, Google Hangouts, Zoom etc. for treatment purposes without risk of HIPPA violation. This notification does not cover any public video applications such as Facebook Live.
CMS states the following:
New patient E/M office and outpatient CPT codes are listed in the CMS list of Medicare telehealth services, however, per the March 17, 2020 Medicare Telemedicine Health Care Provider Fact Sheet; “Accordingly, the Department of Health and Human Services (HHS) is announcing a policy of enforcement discretion for Medicare telehealth services furnished pursuant to the waiver under section 1135(b)(8) of the Act. To the extent the waiver (section 1135(g)(3)) requires that the patient have a prior established relationship with a particular practitioner, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public health emergency.”
CMS is also temporarily waiving requirements that out-of-state providers be licensed in the state where they are providing services when they are licensed in another state. This applies to Medicare and Medicaid.
In this chaotic time HCCS HIM Services is dedicated to helping providers understand and apply all the guidance issued by CMS and President Trump. If your facility or providers need information and/or assistance in navigating the new telehealth, coding or waiver directives please contact as at firstname.lastname@example.org