Deregulation Sparks Dramatic Telehealth Increase During the COVID-19 Response
Encouraging private-sector solutions through targeted deregulation and public-private partnerships is a critical part of the Trump Administration’s COVID-19 response. This approach has successfully expanded testing development, healthcare capacity, and the use of telehealth. Telehealth has grown as the United States continues responding to COVID-19’s challenges, leading to public health benefits.
Telehealth allows patients to connect remotely with medical professionals. Because of advances in smartphones and remote diagnostic testing capabilities, its use recently started to increase. But more comprehensive telehealth adoption was limited due in part to issues with internet access, HIPAA requirements, State licensing laws, provider liability, quality standards, and reimbursement arrangements.
This dynamic changed at the Federal level under President Trump’s deregulatory healthcare agenda. To allow for reforms that support the government’s response to COVID-19, the Secretary of the Department of Health and Human Services (HHS) declared a public health emergency on January 31, 2020. Because of this declaration, and shortly after the President declared a national emergency, the Centers for Medicare & Medicaid Services (CMS) released guidance on March 17 that allows Medicare to pay for telehealth services provided across the country. And just last week, CMS released a new toolkit to help States bring this important benefit to other vulnerable populations through Medicaid.
Concurrently with CMS’s Medicare guidance, the HHS Office for Civil Rights announced it will exercise its enforcement discretion and not impose penalties against covered healthcare providers for noncompliance with the HIPAA Privacy, Security, and Breach Notification Rules in connection with the good-faith provision of telehealth. This change allows patients and providers for all types of healthcare to connect over non-public facing video platforms such as Skype, Zoom, and FaceTime during the national emergency. These policy changes followed a 2018 Department of Veterans Affairs regulation that expanded veterans’ healthcare access to include telehealth and earlier CMS policies to allow virtual check-ins.
Data show that telehealth utilization is increasing because of new flexibilities for the provision of Medicare telehealth services and potentially because of HHS’s policy change that allows providers to use popular video platforms to connect with patients. Additionally, the recently enacted Families First Coronavirus Response Act, as amended by the CARES Act, requires group health plans and health insurers to waive cost sharing for COVID-19 testing and any related provider visits to administer such testing, including telehealth visits. Furthermore, the recent increase in telehealth utilization makes sense, as Federal policies have encouraged alternatives to in-person interaction and there is a need to decrease demands on the healthcare system. While it is difficult to separate whether the surge in telehealth is primarily driven by patients’ and providers’ shifting preferences due to COVID-19, the CARES Act, or private insurance reimbursement policies echoing Medicare’s change, all of these factors more than likely contributed to telehealth’s growth.
As the figure below shows, from March 14 to April 1, daily telehealth claims…