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Coronavirus Telemedicine Information

ArMA Partners with CompuGroup Medical to provide Telemedicine to Arizona Physicians for Free

COVID-19 infections are being detected more and more in the United States. With the spread of infections, the fear of becoming infected increases—not only among the population, but also among you and your practice staff. After all, it is you who are in close physical contact with (potentially) infected people as part of medical treatment. The Centers for Disease Control and Prevention recommends avoiding close contact with other people if there is a suspicion of a coronavirus infection. The risk of infecting others is too great.


Free solution: video consultation


For the care of these (potentially) infected patients, video communication is a simple and, above all, safe solution for all parties. By using a video consultation, you can protect your patients and your team, but also yourself and your family from infection . In this acute crisis situation, CGM therefore offers you CGM ELVI Telemedicine for a limited time, free subscription!   To learn more about this timely benefit, click here and/or call CGM's dedicated line for ArMA members at (602) 680-2255.  

 

The American Medical Association (AMA) has also crafted a useful guide on how you can implement telemedicine today.

 

Telemedicine cannot take the place of testing your patients. However, it can help doctors make special arragnements to safely receive a patient who is sick and suspects the virus may be involved. 

 

Governor Ducey's Executive Order

 

The Governor's Executive Order is aimed at protecting Arizonans and high-risk populations. The order provides the following:

  • Requires insurance companies and health plans to cover out of network providers, including out of plan laboratories and telemedicine providers.
  • Waives all copays, coinsurance, and deductibles for consumers related to COVID-19 diagnostic testing and decrease co-pays for telemedicine visits. 
  • Implements consumer protections, including prohibiting price-gouging on COVID-19 diagnosis and treatment-related services. 
  • Requires symptom checks of healthcare workers and visitors at skilled nursing facilities, nursing homes, and assisted living facilities. 

You can view the full executive order by clicking here

 

Physicians are encouraged to know the resources that are available to them. ArMA has created a COVID-19 webpage with our communications team providing updates every day. ArMA members are also encouraged to participate in our member online community to connect with physicians across Arizona. 

 

CMS Telemedicine Services Coverage

 

For the most up to date information on this topic, it is recommended physicians frequently visit the CMS website

  1. As of 3/17/2020, Original Medicare rules surrounding telemedicine services have been bypassed to allow the use of telemedicine without regard to the location of the patient.
  2. Under the “EXPANSION OF TELEHEALTH WITH 1135 WAIVER”, Medicare can pay for office, hospital, and other visits furnished via telehealth across the country and including in patient’s places of residence starting March 6, 2020.A range of providers, such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers, will be able to offer telehealth to their patients.Additionally, the HHS Office of Inspector General (OIG) is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs.
    1. Until the Public Health Emergency period is over, Medicare patients may use telecommunication technology for office, hospital visits and other services that generally occur in-person.
    2. The provider must use an interactive audio and video telecommunications system that permits real-time communication between the distant site and the patient at home.  Distant site practitioners who can furnish and get payment for covered telehealth services (subject to state law) can include physicians, nurse practitioners, physician assistants, nurse midwives, certified nurse anesthetists, clinical psychologists, clinical social workers, registered dietitians, and nutrition professionals.
    3. It is imperative during this public health emergency that patients avoid travel, when possible, to physicians’ offices, clinics, hospitals, or other health care facilities where they could risk their own or others’ exposure to further illness.  Accordingly, the Department of Health and Human Services (HHS) is announcing a policy of enforcement discretion for Medicare telehealth services furnished pursuant to the waiver under section 1135(b)(8) of the Act.   To the extent the waiver (section 1135(g)(3)) requires that the patient have a prior established relationship with a particular practitioner, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public health emergency.
  3. All Medicare and Medicare Advantage plans can cover telemedicine visits from the patient’s home, but there is no comprehensive list of Medicare Advantage plans that have expanded their coverage. Checking eligibility and benefits should remain part of your usual practice routine.
  4. Coverage includes virtual check-ins and E-visits - including telephone calls (G2012), when initiated by established patients.  These are not restricted by originating site and other Medicare rules.  Time-based, online digital E/M codes (99421, 99422, and 99423) can be covered for established patients. Similar codes (G2061, G2062, G2063) are available for online patient-initiated assessments provided by qualified non-physician health care professionals.  (See the CMS Fact Sheet dated 03/17/2020 https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet)

 

AHCCCS Announces They Will Cover Telemedicine Visits

 

This includes those initiated from the patient's home. For further guidance from AHCCCS, please click here

 

Other Considerations

 

Licensure and liability insurance rules apply equally to in-person visits and telemedicine visits. 

 

To practice telemedicine, doctors often must possess a medical license not only in their home state but in each state where they serve patients. Professional libility coverage may be similarly limited. Be sure to check with your patient to verify their state of residence. This is not to be considered legal advice, but to provide you with enough information for you to perform due diligence. Even if you saw your patient last month, if they have moved their primary residence to another state, you most likely need to be licensed in that state 'see' them via telemedicine. 

 

Arizona licensure rules may prohibit prescribing of medications to patients located outside the state of Arizona. 

 

Again, these requirements are evolving, but check to be sure you are in compliance at the time of service. 

 

Liability Information

 

The Mutual Insurance Company of Arizona (MICA) is a trusted partner of ArMA. MICA has provided the following statement pertaining to liability. 

 

MICA has received an increased number of questions from our insureds and practice managers about their medical professional liability coverage and if it extends to the use of telemedicine. The MICA policy provides coverage to our insureds for patient treatment, including telemedicine, that is within the scope of the health care professional’s medical practice. The health care professional needs to be aware of state licensing requirements if they are treating patients in states other than where they are currently licensed. MICA coverage will apply for licensed insureds providing telemedicine services to patients located in Arizona, Utah, Nevada or Colorado. If your practice extends beyond those states, please contact customer service at (602) 808-2111 to discuss your situation further.