CMS Issues Electronic Toolkit for Providing Telehealth and
Telemedicine in Nursing Homes
Responding to the COVID-19 crisis, the Centers for Medicare & Medicaid Services (CMS) recently issued an electronic toolkit for nursing home facilities to use as a guide for providing expanded access to telehealth and telemedicine services for Medicare covered beneficiaries. That toolkit can be accessed at https://www.cms.gov/files/document/covid-19-nursing-home-telehealth-toolkit.pdf, and contains electronic links to reliable sources of information regarding these CMS recent changes.
There are three main types of virtual services physicians and other professionals can provide to Medicare beneficiaries—Medicare telehealth visits, virtual check-ins, and e-visits. These are summarized in a fact sheet that may be found at
https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet
CMS encourages all providers to share these new abilities to provide healthcare through telemedicine to all patients and residents.
Immediate Key Implementations:
- Medicare is now making payments for professional services furnished to beneficiaries in all areas of the country and in all settings for the duration of the COVID-19 Public Health Emergency.
- Medicare will make payment for Medicare telehealth services furnished to beneficiaries in any healthcare facility and in their home.
- The provider must use an interactive audio and video telecommunications system, including commonly used services like FaceTime and Skype that permit real-time communication between the distant site and the patient at home. Distant site practitioners who can furnish and get payment for covered telehealth services (subject to state law) can include physicians, nurse practitioners, physician assistants, nurse midwives, certified nurse anesthetists, clinical psychologists, clinical social workers, registered dietitians, and nutrition professionals.
- U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) will exercise enforcement discretion and waive penalties for HIPAA violations against health care providers that serve patients in good faith through everyday communications technologies, such as FaceTime or Skype, during the COVID-19 nationwide public health emergency. For more information: https://www.hhs.gov/hiipaa/for-professionals/special-topics/emergency-preparedness/notifcation-enforcement-discretion-telehealth/index.html
- A staff member will need to facilitate the telemedicine experience between the patient and clinician by managing the technology onsite at the nursing home
Compliance Perspective
Failure to follow CMS guidelines when expanding and providing telehealth services to residents in order to give them greater access to physicians and other healthcare professionals during the COVID-19 Public Health Emergency may result in Medicare’s refusing to issue reimbursement payments for claims submitted.
Discussion Points:
- Review policies and procedures regarding the facility’s provision of telehealth services to ensure that CMS guidelines are being carefully followed.
- Train staff regarding the requirement that a staff member facilitate and manage the telemedicine experience between the patient and clinician. Staff training should also include proper documentation of telemedicine services.
- Periodically audit to ensure that a trained staff member is facilitating and managing telemedicine services and that proper documentation of those services is occurring.
