The Office of Inspector General announced today (March 17, 2020) that in response to the outbreak of COVID-19, physicians and other practitioners will not be subject to administrative sanctions for reducing or waiving any cost-sharing obligations that federal healthcare beneficiaries may owe for telemedicine services.
Under normal circumstances, by waving or reducing cost-sharing amounts such as coinsurance, copayments and deductibles, healthcare practitioners could potentially implicate the federal anti-kickback statute, the civil monetary penalty and exclusion laws related to kickbacks, and the civil monetary penalty law prohibition on inducements to beneficiaries.
The notice comes in the wake of the Trump Administration’s announcement that the Centers for Medicare & Medicaid Services (CMS) will temporarily pay clinicians to provide telemedicine services for beneficiaries across the country.
Under this new waiver, effective March 6, 2020, Medicare can pay for telemedicine services in any healthcare facility or in a patient’s home anywhere in the country. These visits are considered the same as in-person visits and will be paid at the same rate as regular, in-person visits.
Prior to this waiver Medicare could only pay for telemedicine on a limited basis, i.e. when the person receiving the service is in a designated rural area and when they leave their home and go to a clinic, hospital, or certain other types of medical facilities for the service.
In addition, some states are taking additional steps to ease restrictions for telemedicine reimbursement by Medicaid and commercial insurers. Currently, Florida does not require health plans to cover telemedicine as a benefit, and its Medicaid programs currently only reimburse for live video telemedicine.
However, this is a fluid situation and things are changing rapidly. If you have any questions we urge you to confer with legal counsel. The Health Law Offices of Anthony C. Vitale is here to assist clients with matters relating to billing as well as those relating to anti-kickback laws and CMPs. If you have any questions or concerns, do not hesitate to contact us at 305-358-4500 or firstname.lastname@example.org