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Monthly Archives

May 2023

United States: Medicare Telehealth And The End Of The Public Health Emergency

By News

Source by: Arnold & Porter
by Monique Nolan Amanda Cassidy, MPP and Hannah Leibson

Throughout the COVID-19 public health emergency (PHE), the Centers for Medicare & Medicaid Services (CMS) used a combination of emergency authority waivers, regulations, enforcement discretion, guidance, and reliance on new legislation to provide broad flexibilities under the Medicare and Medicaid programs. With the expiration of the PHE on May 11, 2023, health care providers should be aware of major changes that are in store regarding reimbursement flexibilities related to Medicare telehealth and other types of remote and virtual care.

An area of significant impact is Medicare telehealth services under Section 1834(m) of the Social Security Act, which ordinarily imposes strict requirements for the delivery of such services. During the PHE, CMS exercised various waiver and statutory authorities to remove certain geographic and originating site restrictions, as well as restrictions on who may furnish telehealth services. The agency also allowed for certain telehealth services to be furnished via audio-only communication technology. Altogether, this paved the way for a new landscape of relaxed telehealth flexibilities over the last three years.

Additionally, the COVID-19 PHE was the impetus for new and/or temporary policies by CMS to provide alternatives to face-to-face and in-person encounters between vulnerable Medicare beneficiaries and health care professionals (and each other), such as through remote patient monitoring (RPM), virtual supervision, and the relaxing of face-to-face service requirements. Initially born out of necessity, health providers and beneficiaries have become accustomed to these policies and this new way of furnishing care.

With the end of the PHE, Congress must act if some of these flexibilities are to become permanent fixtures of the Medicare program. At the same time, CMS must grapple with what it can do under its existing authorities, such as the Section 1834(m) Medicare telehealth provision, particularly in light of lessons learned during the PHE. Indeed, the PHE has forced the agency to reevaluate what services are appropriate for telehealth, particularly in the area of behavioral health services which lends itself to virtual telehealth encounters as compared to other services. Additionally, while CMS adopted certain policies on a temporary basis during the PHE, CMS has signaled that it may be open to making such policies permanent. For example, despite its current plans to return to the pre-PHE direct supervision rules, CMS has previously solicited comments about whether to make the temporary exception (direct supervision through virtual presence) permanent or to apply such policies to a subset of services, and sought additional data or evidence that might justify such a change. Accordingly, this is a key time and opportunity for stakeholders and other interested parties to weigh in on these issues, such as in the upcoming Physician Fee Schedule rulemaking cycle for calendar year 2024, to inform future policy development and, where applicable, potentially persuade the agency to restore or retain certain PHE-related exceptions or flexibilities. As several fraud and abuse waivers expire, adherence to the adjusted policies is critical.

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Senators Reintroduce Bill to Improve Maternal Care Through Telehealth

By News

Source: mHealth Intelligence

By Mark Melchionna


Two US senators have reintroduced a piece of bipartisan legislation to enhance the maternal care process through telehealth and other digital tools.

 – US Senators Bob Menendez (D-N.J.) and Dan Sullivan (R-Alaska) have reintroduced bipartisan legislation known as the Tech to Save Moms Act, which aims to leverage telehealth and digital health technology to promote maternal care outcomes.

The disparities common in healthcare are amplified among US patients seeking maternal care, making the US maternal death rate far higher than that of other comparably resourced countries. These are often racial and ethnicity-based healthcare disparities.

According to the Centers for Disease Control and Prevention (CDC), the maternal mortality rate for non-Hispanic Black women in the US was 69.9 deaths per 100,000 live births in 2021. This rate was 2.6 times greater than that of non-Hispanic White women.

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Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications

By News

Source:  Federal Register

A Rule by the Drug Enforcement Administration and the Health and Human Services Department on 05/10/2023


Drug Enforcement Administration, Department of Justice; Substance Abuse and Mental Health Services Administration, Department of Health and Human Services.


Temporary rule.


On March 1, 2023 the Drug Enforcement Administration (DEA), in concert with the Department of Health and Human Services (HHS), promulgated two notices of proposed rulemakings (NPRMs) soliciting comments on proposals to allow for prescribing of controlled medications pursuant to the practice of telemedicine in instances where the prescribing practitioner has never conducted an in-person medical evaluation of the patient. Those NPRMs resulted in 38,369 public comments, which are being closely reviewed. DEA, in concert with HHS, is considering revisions to the proposed rules set forth in the NPRMs. In the meantime, and following initial review of the comments received, DEA, jointly with the Substance Abuse and Mental Health Services Administration (SAMHSA), is issuing this temporary rule to extend certain exceptions granted to existing DEA regulations in March 2020 as a result of the COVID–19 Public Health Emergency (COVID–19 PHE), in order to avoid lapses in care for patients. Ultimately, there will be a final set of regulations permitting the practice of telemedicine under circumstances that are consistent with public health, safety, and effective controls against diversion.

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The Pandemic-Era Rule That Lets You Get Telehealth Prescriptions Just Got Extended

By News

Source: NPR

When COVID-19 was declared a public health emergency more than three years ago, it signaled the beginning of huge change for the health care industry.

That was especially true for telehealth.

Under relaxed regulations, patients could more easily connect by phone or Zoom to doctors many miles away, or get prescriptions from a specialist to treat conditions like ADHD or opioid use disorder.

The federal declaration — and the pandemic policies tied to it — officially ends on Thursday, but patients may not see any big changes in the care they receive via telehealth, at least not yet.

Federal policymakers are allowing these more expansive telehealth services to remain in place temporarily, thanks in part to a last-minute about-face by the Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Services Administration.

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Telehealth is here to stay, survey shows. How should the industry adapt?

By News

Source: Fierce Pharma

Telehealth use skyrocketed early in the COVID-19 pandemic, accounting for a significant share of all doctors’ appointments at its peak. And while virtual visits have since dipped in volume, telehealth still supports millions of appointments each year. But will the trend continue?

Data from a Phreesia survey completed by nearly 2,000 patients suggests that it will. In 2022, 36% of patients who checked in for a doctor’s appointment on Phreesia’s platform reported having had a virtual healthcare visit in the past six months. Satisfaction was high, with 71% of those recent telehealth users saying they were very or extremely satisfied with virtual visits as a care option.

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