Medicare, Medicaid patients now have access to certain telemedicine options
Due to the international health crisis caused by the spread of COVID-19, the Trump administration has been taking steps to allow Medicare and Medicaid recipients access to previously restricted health care options.
ABC News reports that on Monday, the administration took the unprecedented step to temporarily waive certain rules so as to allow some healthcare providers to conduct phone-only visits with their patients.
So, CMS has temporarily expanded telehealthcare policies, but it still does not allow therapy services by phone.
#ICYMI: Addressing the #COVID19 patient surge, CMS issued an unprecedented array of temporary regulatory waivers and new rules to equip the American healthcare system with maximum flexibility. https://t.co/woZPEPidGM pic.twitter.com/bka7Up0EBK— CMSGov (@CMSGov) March 31, 2020
CMS covers at least 140 million Americans through Medicare, Medicaid, the Children’s Health Insurance Program, and Federal Exchanges – typically covering a constituency of people with disabilities, the elderly, and those with low incomes, many of whom may be unable to access the advanced technologies required for telehealth -- seen as an important emerging tool in maintaining people's health amid the fight against the virus.
“Access to phone-only services is a health equity and social justice issue,” said Dr. Jared Skillings, the Chief of Professional Practice for the American Psychological Association. “Many patients and some providers do not have access or capability to use cellphones with video chat. They may also not have internet service or broadband speed.”
That’s why leaders in the medical field pushed – and are continuing to advocate for – CMS, state regulators, and private insurance companies to expand their policies to accommodate situations where simultaneous two-way audio and video capabilities are impossible.
But challenges still remain.
While CMS expanded access to neuropsychological and psychological testing by allowing telehealth for the first time, it still does not cover ?typical therapy services by phone, according to Dr. Stephen Gillaspy, APA’s director of health care financing.
This temporary deregulation – that ignored therapy sessions – came just a day after President Trump suggested that there will be a rise in depression, saying "You're going to have mental depression for people. You're going to have large numbers of suicides.” And yet, access to phone-only therapy for Americans covered by CMS is unavailable.
“Now, that makes no sense for all kinds of vulnerable populations, older adults, people with lower-income, folks with disabilities," said Skillings. "I'll give you the best example I have heard from one of my best friend colleagues -- she said, ‘Why should people who are visually impaired have to do a video chat?’ That makes no sense.”
Additionally, the regulatory waiver is only temporary.
CMS is federally run, but insurance – including telehealth policies – is regulated at the state level. Every state and every private health insurance company has different policies. To add to the complexity, tens of millions of Americans are not insured, and tens of millions more are on self-insured plans, which have different policies than those who are fully insured.
Because there isn’t a one-answer-fits-all policy nationwide, patients can have a hard time recognizing which policy applies to them, furthering the difficulty of finding the proper care they need.
And because it is fundamentally up to the states to adopt these new rules and regulations, this will result in a fragmented adoption of policies and make it more difficult for multi-state providers according to Dr. Bill Mills, Chief Medical Officer at BrightSpring Health Services, a large, multi-state provider of intellectual or developmental disability and behavioral health services.
“As this goes forward, the people who are the most vulnerable already are also going to be the people who are the most impacted by this crisis,” said Skillings. “And so therefore, we need to make sure we take the most care -- we need to take care of everybody -- but we need to make especially sure we take care of them too.”
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