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Preparing Your Data for a Post-COVID-19 World

The US healthcare system’s data infrastructure needs an overhaul to prepare for future health crises, streamline patient care, improve data sharing and accessibility among patients, providers and government entities, and move toward the delivery of coordinated care. With insights from leaders from Arcadia, Validic and McDermott, we recently discussed key analyses and updates on the interoperability and application programming interfaces (API) criteria from the 21st Century Cures Act, stakeholder benefits of healthcare data exchange and data submission facilitation for public health purposes. Click here to listen to the webinar recording, and read on for highlights from the program.

To learn more about the “Around the Corner” webinar series and attend an upcoming program, click here.

PROGRAM INSIGHTS

  • COVID-19 is reshaping healthcare through technology. Hospitals, clinicians and payors need to use digital health tools to address the challenges of the coronavirus (COVID-19) public health pandemic. How COVID-19 data and health information are captured, and then move through electronic systems, will form the foundation by which digital health tools can become effective in identifying cases, treating them and ensuring favorable outcomes.
  • API certification requirements under the 21st Century Cures Act are designed to enhance the accessibility of electronic health information. The 21st Century Cures Act’s purpose is to advance interoperability, address information blocking, support seamless exchange of electronic health information and promote patient access. Putting data from electronic health records (EHRs) into patients’ hands through consumer-facing apps will empower them to understand and take control of their health.
  • EHR vendors will be required to offer APIs that comply with the Fast Healthcare Interoperability Resource (FHIR) standard by May 1, 2022. The 21st Century Cures Act Final Rule will require EHR vendors to offer FHIR based APIs that make electronic health information more readily available to third-party applications (apps) of patients’ and providers’ choosing. API standardization will make it easier for third-party developers to build these apps, and for patients and providers wishing to use third-party apps to leverage their electronic health information for various purposes, including health information exchange and population health management.

 

  • Interoperability refers to the standards that make it possible for different EHR systems to exchange patient medical records and information between providers. Increased interoperability between EHR systems using harmonized standards allows for a more seamless transfer of patient data between providers. The interoperability requirements in the 21st Century Cures Act have the potential to advance patient access to their data and the use of information among physicians.
  • Both providers and patients can drive data exchange. One challenge impacting data exchange between patients and providers is that providers cannot always access or integrate data that patients have created with third-party tools (e.g., fitness trackers). However, there is emerging technology designed to aggregate and standardize consumer-generated health information, enabling the [...]

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Around the Corner: The Future Of Telehealth After COVID-19

Prior to the pandemic, health providers and stakeholders were quickly moving to develop and expand existing telehealth programs. Now we are seeing an adoption of telehealth solutions that far surpasses all of the activity we saw in the past five years combined.

Joined by leaders from BDO, Babylon Health, Crossover Health and the Illinois Bone & Joint Institute, we discussed what the future of digital provider/patient engagement may look like after COVID-19 and the legal factors that influence implementation. Telehealth is the new normal and there is no turning back.

Bar graph with poll results.

PROGRAM INSIGHTS

  • There is now recognition that telehealth can, in fact, replace in-person visits in many situations. Patients and healthcare providers have quickly turned to telehealth to provide care for existing and new healthcare conditions during the pandemic. This increase in use has provided additional data demonstrating the value of telehealth. In addition to telehealth visits, patients are looking to patient care navigators and wellness advisors for basic healthcare information that can empower them to manage their healthcare needs before seeking treatment from a licensed healthcare professional.
  • The regulation of telehealth on a state-by-state basis is an ongoing hindrance to telehealth providers in the United States. While the state waivers on professional licensure and care delivery during the COVID-19 public health emergency have temporarily lowered some of these barriers, these waivers have or will soon expire in many states, once again leaving telehealth providers with the burden of developing complex compliance strategies that differ from state to state.
  • For telehealth to achieve its full potential, it needs to be freed from the constraints that apply to in-person episodic care. In doing so, remote monitoring can meaningfully engage patients in real time to actively manage care on an ongoing basis, without interruptions or the need for a pre-scheduled visit.
  • The COVID-19 pandemic is digital health adrenaline – forcing people rapidly and without warning to pivot to telehealth. But when technology works well and effectively, demand will persist well beyond the catalyzing event. If patients receive superior quality care through digital technologies and superior convenience, this improved experience will force the traditional healthcare delivery process to continue its changed approach.
  • The healthcare transactional business model is a challenge that holds back widespread adoption of telehealth. Now that lawmakers have data that demonstrates the value of telehealth, reimbursement codes for different delivery modalities will need to be reevaluated. This reevaluation will future catalyze greater adoption of telehealth by providers as payments will align more appropriately with the services delivered.

For a deeper dive into these topics, please listen to our webinar recording, available here.




Florida’s Extension of its COVID-19 Out-of-State Provider Waiver: A Sign of the Times

Background: Issuing Florida’s Emergency Order

On March 16, 2020, Florida Surgeon General Dr. Scott Rivkees signed, stamped and finalized Emergency Order 20-002. In doing so, Florida joined what would become the vast majority of states in modifying licensure requirements for physicians in response to the Coronavirus (COVID-19) emergency.

The surgeon general’s order waived licensing requirements for out-of-state healthcare professionals, advanced life support professionals and basic life support professionals so that they could render services in Florida for the purposes of preparing for, responding to and mitigating any effect of COVID-19. In addition to waiving licensing requirements for in-person services, the order exempted out-of-state physicians, osteopathic physicians, physician assistants and advanced practice registered nurses from licensing requirements governing the provision of telehealth. The order also impacted emergency medical services training programs, physical examination requirements for physician certifications, prescription drug distribution and controlled substance prescription renewals (including medical marijuana). The order was to expire 30 days after signing—April 15, 2020.

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Telemedicine COVID-19 Briefing: March 16

Government, media and industry have all pointed to the potential for telemedicine to assist in combating the COVID-19 pandemic. In addition, steps have been taken by the government to ease the burdens associated with the use of telemedicine during this crisis. Unfortunately, the complexity of the regulatory infrastructure has left a fair amount of confusion with respect to the extent to which rules have been, and may be, liberalized. At a time when our healthcare infrastructure is engaging with a health crisis that will get worse before it gets better, confusion about the requirements for care delivery needs to be reduced to a minimum.

Please join us on Monday, March 16 from 1 – 2pm ET for an update on:

  • Loosened Medicare reimbursement requirements
  • State emergency efforts
  • Related issues associated with the delivery of telemedicine services during the COVID-19 pandemic

CLICK HERE TO REGISTER




Bipartisan Bill Relaxes Federal Telehealth Requirements in the Wake of COVID-19

On March 4, 2020, the House passed the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, a bipartisan bill to aid in COVID-19 preparedness and response. The bill includes, among other things, provisions that waive certain telehealth requirements during the COVID-19 public health emergency to ensure Medicare beneficiaries can receive telehealth services at home to avoid placing themselves at greater risk of the virus.

Generally, Medicare beneficiaries may only receive telehealth services as a Medicare covered service if:

  • The beneficiary (patient) is located in a qualifying rural area;
  • The beneficiary is located at one of eight types of qualifying originating sites;
  • The services are provided by one of 10 categories of distant site practitioners eligible to furnish and receive Medicare payment for telehealth services;
  • The beneficiary and distant site practitioner communicate via an interactive audio and video telecommunications system that permits real-time communication between them—telephones, fax machines and email do not meet this requirement; and
  • The CPT/HCPCs code for the service is on the list of covered Medicare telehealth services.

The bill gives the secretary of the US Department of Health and Human Services (HHS) the authority to waive the originating site requirement for telehealth services provided to Medicare beneficiaries located in any identified emergency area during emergency periods by a qualified provider. An “emergency area” is a geographical area in which, and an “emergency period” is the period during which, there exists: (a) an emergency or disaster declared by the president pursuant to the National Emergencies Act or the Robert T. Stafford Disaster Relief and Emergency Assistance Act; and (b) a public health emergency declared by the secretary. The bill also allows telehealth services to be provided to Medicare beneficiaries via phone, but only if the phone allows for audio-video interaction between the provider and the beneficiary.

The bill takes important steps to allow healthcare providers to deploy telehealth resources in response to COVID-19 and other public health emergencies, and allows Medicare beneficiaries to receive telehealth services from the comfort of their home (even via their smart phone) without risk of exposure. While the bill represents a further step in the expansion of the availability of telehealth services, we should be careful not to overstate its impact. The waiver of the originating site requirement and expansion of telemedicine modalities is limited to emergency areas identified by the president and secretary during emergency periods. Accordingly, as a practical matter, this expansion of availability of telehealth reimbursement is very limited. In addition, healthcare providers must still comply with state laws and regulations that govern telehealth, including, but not limited to, professional licensure, scope of practice, standard of care, patient consent and other reimbursement requirements for non-Medicare beneficiaries.

The bill offers a welcome relaxation of the rigid Medicare requirements for telehealth reimbursement during a time of stress within the healthcare industry. It also represents another, albeit small, step in the gradual acceptance of telehealth within the healthcare reimbursement sector.




Coronavirus Resource Center | Preparedness Planning for Businesses

In our global economy, Coronavirus (COVID-19) raises serious concerns for employers in all industries. Workers may be on the front lines caring for patients and developing vaccines, travelling for business, or in close contact with individuals who travel or may have been affected. At this time, there is no vaccine or medication approved to prevent or treat the COVID-19 disease. Therefore, preparedness and prevention are crucial. Frontline responders must be especially vigilant as they deliver care and anticipate the challenges this uncharted territory presents.

McDermott’s Coronavirus Resource Center, brought to you by a multi-disciplinary team, will keep you informed of the latest developments and provide comprehensive insight to help you navigate this crisis with your employees, including:

  • Frequently asked questions for US and multi-national employers
  • Recent news updates
  • Podcasts
  • Upcoming events

Click here to access the Resource Center.




The Role of Telehealth in COVID-19 Response Efforts

As the number of confirmed COVID-19 cases in the United States grows, healthcare providers are stepping up their response planning. To combat the spread of COVID-19, the Centers for Disease Control and Prevention (CDC) urged healthcare systems and providers to deploy all of the resources necessary to ensure health system preparedness. The CDC recommended the use of telehealth tools to help address COVID-19 preparedness and to assist in directing patients to the right level of healthcare for their medical needs.

Healthcare providers have a unique and pressing opportunity to offer telehealth services to potential COVID-19 patients. At the same time, healthcare providers’ response to the COVID-19 outbreak highlights some of the barriers to the provision of telehealth services. Providers considering using telehealth as part of their COVID-19 response efforts should take the following factors into consideration:

  • While healthcare providers cannot diagnose COVID-19 through a telehealth visit, they can perform a number of services without requiring a patient to visit crowded medical facilities where the virus might be present. These services include performing initial patient screenings, assessing and assigning risk categories to patients, determining if a patient needs to seek diagnostic testing, and answering patient questions and offering treatment recommendations.
  • Deploying telehealth services is not without its challenges. The varying reimbursement policies of private, state and federal payers, as well as differing state-based medical licensing requirements, may burden providers and patients with confusion, economic inefficiencies and onerous processes in a difficult engagement context.
  • As part of the COVID-19 response discussions, telehealth advocates propose that the Centers for Medicare and Medicaid Services reduce or eliminate its long-standing telehealth reimbursement restrictions. This change would allow Medicare to pay for virtual visits during national emergencies, regardless of originating site or geographic location. There is also a push to waive the lengthy enrollment process telehealth providers must undergo to be paid by Medicare.
  • While telehealth has the potential to assist in a healthcare system’s response to COVID-19, providers still must comply with state laws and regulations that govern telehealth, including but not limited to professional licensure, scope of practice, standard of care and patient consent, in addition to the reimbursement requirements and limitations put into place by third-party payers.
    • Typically, telehealth providers must be licensed in the state in which the patient is located, although certain states have exceptions that telehealth providers may leverage in response to COVID-19.
    • Telehealth providers must practice within the scope of practice of the profession in which they are licensed and within the standard of care set forth by the governing professional board in a given state.
    • State telehealth laws may require a specific modality for telehealth consultations (e.g., audio-visual consultations). Likewise, third-party payers may require a specific modality for telehealth consultations for purposes of reimbursement.



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