NCUIH Resource: COVID-19 and Telehealth for Urban Indian Organizations

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Contact: Andrew Kalweit, akalweit@NCUIH.org

COVID-19 & Telehealth at Urban Indian Organizations

Reimbursement for Telehealth Services has been expanded. Adopting telehealth may help treat an influx of COVID-19 patients while providing routine care to others.

Key Facts

• Medicare now allows reimbursement for Urban Facilities
• Virtual check-ins can use a broad range of devices and phones
• State Medicaid programs are expanding reimbursement
• Many private insurers have embraced the platform at parity to in-person services

General Resources & Start-Up Guides

• CMS General Provider Telehealth and Telemedicine Tool Kit
• CMS Telehealth Services for Medicare FFS Providers
• CMS Telemedicine Toolkit for End Stage Renal Disease
• COVID-19 Telehealth Toolkit, with free support from the National Consortium of Telehealth Resource Centers
• Updated Department of Justice Guidance on telemedicine and the prescription of controlled substances
• Updates and Technical Assistance from the IHS TeleBehavioral Health Center of Excellence and their Step-by-Step Setup Guide
• A detailed list of state and federal policy updates due to COVID-19, from the Center for Connected Health Policy (CCHP).
• The CCHP also provides a detailed report covering relevant state and federal laws, eligible services, and reimbursement policies, apart from these COVID-19 updates.

Summary of Updates

Medicare Fee-for-Service

Provide Telehealth Visits, Virtual Check-ins, and E-visits

• Medicare reimbursement is now allowed in urban areas
• All services allow patients to initiate encounters from their home
• Telehealth visits can be with new or established patients
• E-visits and brief “virtual check-ins” can be reimbursed:
  • for emails, calls, texts, and audio/video streaming
  • with established patients
• Eligible providers are:
  • Physicians
  • Nurse practitioners
  • Physician assistants
  • Nurse-midwives Clinical nurse specialists
  • Certified registered nurse anesthetists
  • Clinical psychologists (CP)
  • Registered dietitians or nutrition professional
• See the CMS Fact Sheet for this 1135 waiver, the list of eligible codes, and FAQs.
• Medicare has Waived licensing requirements that health care professionals hold licenses in the state in which they provide services.*

Medicaid

• State Waivers have expanded opportunities for reimbursement
• Policies vary between states, but updates have been collected online.
• For a good guide for services in your state that were already reimbursable prior to COVID-19, see the 2019 CCHP Report.

Private Insurers

• Many payers have made announcements on telehealth during this pandemic, such as Aetna, Cigna, and BlueShield BlueCross