Healthcare

Ohio Department of Medicaid Starts Process to Make Telehealth Services Permanent

A: Based on a significant increase in the usage of telehealth services, ODM now wishes to make the expansion permanent.

Prior to the COVID-19 pandemic, ODM providers submitted less than 1,000 telehealth claims per month for physical health services, and around 4,000 telehealth claims per month for mental health and addiction services.  Since the implementation of the temporary rule, ODM providers have submitted 1.3 million claims for physical health services, and 1.28 million claims for mental health and addiction services.

A: The proposed rule includes a change in the definition of telehealth.  Formerly, telehealth consisted of health care services provided by secure, synchronous, interactive, real-time electronic communication between the patient and the practitioner with both audio and video elements.  Under the proposed rule, telehealth would now include health care services that are provided via a communication that is asynchronous or that does not have both audio and video elements, including telephone calls, remote patient monitoring, and communication through secure e-mail and patient portals.  Under the previous rule, these activities were not considered telehealth.

The proposed rule also increases the types of practitioners eligible to render telehealth services to ODM patients. Additional eligible practitioners include dentists, optometrists, audiologists, and occupational and physical therapists.

A:

• Remote evaluation of recorded video or images submitted by an established patient;
• Virtual check-in by a physician or other qualified health care professional who can report evaluation and management services, when provided to an established patient;
• Online digital evaluation and management services, when provided to an established patient;
• Remote patient monitoring;
• Audiology, speech-language pathology, physical therapy, and occupational therapy services;
• Limited or periodic oral evaluation; and
• Optometry services.

A: The proposed rule is currently under review by the Joint Committee on Agency Rule Review, with a hearing scheduled for October 1, 2020.  ODM anticipates the review being completed and the rule being approved before the current temporary rule expires on November 14, 2020.

Stimulus Payments

A: As part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, the U.S. Department of Health and Human Services (HHS) began distributing $30 billion on Friday, April 10, 2020 to U.S. medical providers who received Medicare fee-for-service (FFS) reimbursements in 2019.

A: The funds, which are not loans and do not need to be paid back, are being directly deposited into providers’ accounts.

A: Providers are receiving about 1/16^th of his/her Medicare FFS reimbursements in 2019 in the form of a stimulus payment. If a provider did not bill Medicare in 2019 for FFS, the provider will not receive money from this distribution.

A: The funds are meant to be used to cover health care-related expenses or lost revenue due to the coronavirus pandemic. Examples of expenses identified in the CARES Act include building or construction of temporary structures, leasing of properties, buying medical supplies, personal protective equipment and testing supplies, increasing one’s workforce and holding trainings, and retrofitting facilities. However, providers can essentially use the funds as they see fit, as long as they do not use them to reimburse expenses or losses that have been reimbursed from other sources, or that other sources are obligated to reimburse.

A: Providers are required to document how the stimulus payment is used. They will also be required to submit reports to ensure compliance with the payment. But details of what those reports will entail have not been made available yet.

A: Those who receive stimulus payments from HHS are not exempted from receiving other forms of relief.

A: The $30 billion distribution is part of $100 billion relief fund appropriated in the CARES Act to the Public Health and Social Services Emergency Fund (PHSSEF), also called the CARES Act Provider Relief Fund.

A: HHS intends to distribute more relief funds in the future, particularly to providers hit hard by the pandemic as well as those who serve rural areas, the Medicaid population and the uninsured, and those with lower shares of Medicare FFS reimbursement.