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Melissa Ward
Sr. Business Analyst - Regulatory Affairs

Welcome back to another edition of Zipnosis Regulatory Roundup! For this month, let’s look at where the latest telehealth regulations are and what’s been happening this past month.

virtual care regulation

Federal

The Centers for Medicare and Medicaid Services (CMS) released the 2022 Medicare Part B Physician Fee Schedule. Some telehealth highlights of note:

  • The Consolidated Appropriate Act (CAA), that passed in December 2020 included a statue requiring an in-person mental health visit prior to qualifying for telehealth services. CMS did not have authority to modify this requirement so it must stand but CMS did have authority on subsequent in-person requirements. CMS will require an in-person with the provider or a provider in the same practice every 12 months thereafter. CMS’ original proposal was every 6 months.
  • Allows for audio-only behavioral health visits:
    • Must be an established patient
    • Provider must have the capability for audio/video but the patient declines video or does not have the technology needed – a modifier will be required and the document must support the medical necessity of audio-only
  • Allows the home as an originating site – updated definition of “home” to include temporary housing (hotel, homeless shelter)
  • Will allow Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHC) to serve as distant site providers for behavioral health and will reimburse for the services, including audio-only visits. These sites are subject to the same in-person requirements and technology capabilities as fee-for-service providers.
  • Added cardiac rehabilitation CPT codes 93797-98 and G0422-23 to the Category 3 list and allows providers to bill all Category 3 CPT codes through 2023.

$1.5 Billion Investment Announced

On November 22, 2021, the Biden Administration announced it will invest $1.5 billion in the healthcare workforce and initiatives to improve equitable health care in high-risk communities and areas hard-hit during the COVID-19 pandemic. The funds will provide awards supporting the National Health Service Corps, Nurse Corps, and substance use disorder treatment recovery programs. These programs help mitigate workforce shortages through scholarships and loan repayment programs to doctors, dentists, nurses, and behavioral health providers committed to working in underserved communities.

virtual care regulation

By State

Florida Senate Bill 312 – Passed the Health Committee (1st Committee)

This bill seeks to amend the ban on prescribing certain controlled substance by allowing providers to renew prescriptions for Schedule III, IV, or V substances via telehealth, including audio-only. 

Maine Board of Licensure – Draft Rule for Telehealth Issued

In response to 2021 state legislative changes, the board of medicine, osteopathic licensure, and state board of nursing have released a joint draft of rules that include definition changes, an expanded list of eligible providers, and updates to practice language. The updates are proposed to be placed in Chapter 11: Joint Rule Regarding Telehealth Standards of Practice. The comment period is open until December 10, 2021.

New Jersey Senate Bill 309 – Conditionally Vetoed

 This is a bill we have been watch for months as it addresses telehealth payment parity and standards of practice allowing greater flexibilities for telehealth provision. The passed the senate and has been sitting on Governor Murphy’s desk for months. As anticipated, he conditionally vetoed the comprehensive bill. The governor has extended parity until the end of 2023 while a commission studies the impact of parity on providers and health insurance plans.

Wisconsin Senate Bill 309 – ENACTED!

The state has updated the definition of “telehealth” to one that is technology neutral. The bill also limits professional boards from narrowing the definition.

440.01 (1) (hm)
“Telehealth means a practice of health care delivery, diagnosis, consultation, treatment, or transfer of medically relevant data by means of audio, video, or data communication that are used either during a patient visit or a consultation or are used to transfer medically relevant data about a patient. Telehealth includes asynchronous telehealth services, interactive telehealth, and remote patient monitoring.” 

440.17 Telehealth
“If the department, an examining board, or an affiliated credentialing board promulgates rules related to telehealth, the department, the examining board, or the affiliated credentialing board shall define “telehealth” to have the meaning given in s. 440.01 (1) (hm).”

Thanks for checking in for this month’s updates. I hope you learned something. Check back next month for more!

Disclaimer:
This information, and any other information, content or other materials (collectively “Information”) we provide, does not, and is not intended to, constitute legal advice; instead, all Information is provided for general informational purposes only. The Information may not constitute the most up-to-date legal or other information.  Readers should contact their attorney to obtain advice with respect to any particular legal matter. No reader or user of any Information should act or refrain from acting on the basis of Information without first seeking legal advice from counsel in the relevant jurisdiction. Only your individual attorney can provide assurances that the Information – and your interpretation of it – is applicable or appropriate to your particular situation. Use of, or access to, the Information does not create an attorney-client relationship between the reader or user, and the author or provider of the Information.

Tags: Industry

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