Last week, the Centers for Medicare & Medicaid Services (CMS) announced major temporary expansions to existing telehealth policies under Medicare in an effort to enable patients to communicate with their doctors remotely during this national emergency.
From the moment CMS put out this guidance, many of you have reached out with questions about what this means for emergency physicians and emergency medicine more generally. ACEP staff have been in constant contact with CMS to try to answer your questions and resolve outstanding issues. Here is an overview of what we know and what we are continuing to work out with CMS.
What we know
Although providing emergency telehealth services during a federal emergency is critical, it was unclear at first from CMS’ guidance whether emergency physicians could in fact deliver telehealth services. After extensive outreach to CMS, we were able to receive this official guidance:
Medicare and Medicaid are covering emergency telehealth services.
Reimbursement of telehealth in Medicaid varies by state.
What we are still waiting on
One common question we’ve received is whether the medical screening exam (MSE), which is a requirement under Emergency Medical Treatment and Labor Act (EMTALA), can be performed via telehealth.
The answer right at this very moment is “no.” However, CMS is working on revising EMTALA guidance to allow MSEs to be delivered via telehealth. We have been actively working with CMS on this guidance and believe that it will be released soon.
In our communications with CMS, we have emphasized how critical this EMTALA guidance is. For example, earlier this week, a member of ACEP’s Board of Directors, Dr. Alison Haddock, raised the issue on a call with the CMS Administrator, Seema Verma, on Tuesday. Dr. Haddock told Administrator Verma directly that this guidance would help protect emergency physicians from unnecessary exposure to the virus and help preserve our limited supply of personal protective equipment.
Lastly, we have heard that many of you would like to use the traditional ED E/M codes when delivering emergency telehealth services—as these codes better reflect the intensity of emergency services than the office and outpatient E/M codes do. Please know that we are actively pushing CMS to add these codes to the list of approved Medicare telehealth services. CMS is working on a COVID-19 regulation now that should be released by the end of the week, and CMS may address this issue in that reg.
We will keep you updated as CMS continues to revise its telehealth-related guidance. We also recognize you have questions on other issues besides telehealth. CMS and other federal agencies are constantly putting out new guidance in response to the COVID-19 pandemic. We are reviewing guidance as it comes out and posting key information on our website.
Until next week, this is Jeffrey saying, enjoy reading regs with your eggs!
Unfortunately, the Regs & Eggs podcast has been indefinitely suspended during the COVID-19 pandemic.
Hungry for more Regs & Eggs? Click here for previous editions.
Want Regs & Eggs delivered fresh? Click here to sign up for our email list.
Want to take your Regs & Eggs to go? Click here to download the Regs & Eggs podcast.
If you have any questions or want to weigh in on other regulatory items, feel free to email me: email@example.com.
Jeffrey Davis is the Director of Regulatory Affairs at the American College of Emergency Physicians (ACEP). He manages ACEP’s formal response to federal policies and works with federal agencies and other stakeholders to help advance ACEP’s federal affairs agenda. Prior to that, Jeffrey worked in the Budget Office at the U.S. Department of Health and Human Services for nearly eight years. Jeffrey came to the Government as a Presidential Management Fellow, and in his position in the Budget Office, he advised top level officials on major budgetary and policy considerations within Medicare and prepared detailed analyses of Medicare regulations and legislation. Jeffrey has a Masters of Science in Health Policy and Management from the Harvard T.H. Chan School of Public Health and a Bachelors of Arts degree from Duke University.