Legal Summary
The Future of Telemedicine William H. Maruca, Esquire In 1962, the Hanna-Barbara cartoon series The Jetsons depicted the futuristic world of 2062, in which suburban office workers commuted in flying cars, Rosie the robot handled housekeeping chores, and doctor visits were conducted by videoconference. In 2022, many employees work primarily from home and don’t need flying cars, Roombas do the vacuuming, and telemedicine visits have become commonplace. The rapid growth of telecommuting and telemedicine got a boost from the COVID-19 public health emergency (Roombas, not so much), but as the pandemic finally begins to recede, the special approvals and exceptions granted for telemedicine are being reevaluated. Recent legislation ensures that remote delivery of healthcare as we have come to know and rely on it will continue for at least a while after the emergency is officially over, and that extension will give policymakers a window of opportunity to enact permanent changes. The Consolidated Appropriations Act, 2022 (“2022 CAA”) was signed into law on March 16, 2022, and extends the COVID-19 Medicare
telehealth waivers and flexibilities for an additional 151 days after the official end of the federal Public Health Emergency (“PHE”). The 2022 CAA was an omnibus spending bill that authorized $1.5 trillion in federal expenditures and included the telehealth extensions along with funding for all federal agencies for the remainder of fiscal year 2022. As of this writing, the PHE is set to expire on April 16, 2022, but it is expected to be renewed until at least July. The special rules that will now continue for five months after the PHE ends are as follows:
Geographic requirements for telehealth: Before COVID-19, telehealth visits were only reimbursable by Medicare in specified facilities such as hospitals and Federally Qualified Health Centers. Under the PHE, those location requirements were waived, and telehealth services were reimbursable when delivered to the patient at any location within the United States, including the patient’s home (the patient’s location is referred to as the “originating site.”) The 2022 CAA continues the waiver for 151 days after the end of the PHE.
Expansion of practitioners eligible for telehealth reimbursement: Under the COVID-19 PHE rules, occupational therapists, physical therapists, speechlanguage pathologists, and qualified audiologists are eligible for Medicare reimbursement for telehealth visits along with physicians, and those practitioners will remain eligible for 151 days after the PHE ends under the 2022 CAA.
Extending telehealth services for FQHCs and RHCs. Federally Qualified Health Centers and Rural Health Clinics will continue to be able to serve as both originating sites and “distant sites” (the location of the provider) for 151 days after the PHE ends. Prior to the PHE they could only serve as originating sites. In-person requirements for mental health: Medicare coverage of telemedicine mental health visits would require an in-person exam within six months of the first telehealth service and subsequent in-person visits every 12 months, effective immediately after the PHE ends based on 2020 changes. Such in-person visit requirements will now not be required until 151 days after the end of the PHE. Continued on Page 26
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