The Expansion in Telehealth through the CARES Act

The recently enacted Coronavirus Aid, Relief, and Economic Security (“CARES”) Act strongly supports the use of telehealth, removes barriers to its use, and undeniably acknowledges that access to telehealth is fundamental in defeating the COVID-19 pandemic. Telehealth is a powerful technology that enables patients geographically separated from healthcare providers to more easily access health care and speed up diagnosis and treatment. Telehealth is especially valuable in light of the highly contagious nature of COVID-19 because telehealth limits the risk of person-to-person exposure, thus thwarting the spread of the viral disease. The CARES Act will help America’s healthcare providers to migrate their patients to virtual care platforms which reduce exposure to COVID-19. The Act contains provisions which will expand the use of telehealth services both during the current COVID-19 pandemic (“emergency period”) and beyond with respect to Medicare beneficiaries, veterans, rural care, hospice care and home health services, and individuals with Health Savings Accounts (“HSA”).

CARES Act telehealth provisions build on the initial Medicare Telehealth Waiver authorized by Congress earlier in March 2020 by removing the requirement that a provider must have seen the patient within the last three years. This allows Medicare beneficiaries to more easily access care when and where they need it during the COVID-19 pandemic. This will enable beneficiaries to access telehealth, including in their home, from a broader range of providers, and will thereby reduce potential exposure to and spread of COVID-19. The CARES Act requires the U.S. Department of Health & Human Services to issue clarifying guidance encouraging the use of telecommunications systems, including remote patient monitoring, to furnish home health services consistent with the beneficiary care plan during the emergency period. During the emergency period, qualified hospice providers can use telehealth technologies to fulfill Medicare’s face-to-face recertification requirement.

Veterans Administration (“VA”) facilities will receive $14.4 billion in funding for the provision of healthcare services through telehealth as well as for the purchase of medical equipment and supplies, testing kits, and personal protective equipment. Included in that funding is $2.15 billion, which is dedicated to the VA’s information technology to support increased telework, telehealth, and call center capabilities to deliver healthcare services directly related to coronavirus and mitigate the risk of virus transmission including the purchasing of devices, as well as enhanced system bandwidth and support. Also authorized under the CARES Act is the VA’s expansion of mental health services delivered via telehealth and authorization for VA to enter into short-term agreements with telecommunication companies to provide veterans with temporary broadband services.

The CARES Act permits individuals with HSAs that are insured through high-deductible health plans to use telehealth services without the need to first reach a deductible. This provision should allow patients who may have the COVID-19 virus to obtain medical consultation from home and thus protect other patients and caregivers from potential exposure. However, this is a temporary provision that will expire on December 21, 2021.

The Health Resources and Services Administration will receive $180 million to assist Federally Qualified Health Centers (“FQHC”) and Rural Health Clinics (“RHC”) in providing telehealth services. During the emergency period, FQHCs and RHCs may serve as “distant sites” (i.e., the location of the healthcare provider) for telehealth consultations. Thus, FQHCs and RHCs can furnish telehealth services to Medicare beneficiaries in their home, and Medicare will provide reimbursement for these such services.