As more and more patients seek to avoid exposing themselves to COVID-19 (also known as coronavirus) in crowded waiting rooms, more and more healthcare practitioners are considering implementing telemedicine services. These efforts have been supported by the federal government, which recently announced that Medicare enrollees could receive telemedicine services at no additional cost. The State of Maryland Department of Health has followed this trend by expanding its regulatory authority to ensure that medical providers can temporarily provide telemedicine services to Medicaid-enrolled patients from the providers’ homes.
If you are a healthcare provider who is not currently providing telemedicine services but wants to expand into that area, there are several areas you should consider.
Liability. You should ensure that your professional liability insurance policies cover telehealth services. Contact your insurance provider and confirm whether your provider provides telehealth coverage, including what specific services are or are not covered, whether certain activities are precluded, and what conditions must be met to ensure coverage. If your provider does not cover telehealth services, confirm how much it would cost and what would need to be done in order to get it covered.
Reimbursement. Maryland law requires that third party payors and managed care organizations that contract with Medicaid reimburse for diagnoses, consultations, and treatments provided using telehealth services. You should ensure that all telehealth services are delivered in a way that satisfies the same requirements as in-person services, that your records demonstrate that their care was delivered appropriately, that the telehealth services are covered benefits, and that you are using the appropriate codes to indicate where the service was provided. For Medicaid, you should ensure that you and your patients are enrolled in the correct programs, that you comply with all preauthorization requirements, and that services and billings are provided in the same manner as for in-patient services. For Medicare, you should confirm that you are qualified to provide telehealth services, that the beneficiaries are located at appropriate sites, and that you are using the appropriate means of communication with the patient. It is important to consult with an attorney to confirm that you meet all applicable requirements to ensure that you are eligible to receive Medicaid and Medicare reimbursements.
Selecting Telehealth Vendors. When selecting vendors, consider exactly what you need from vendors to effectively run a telehealth practice. Carefully vet your vendors with regard to their experience, references, and privacy policies. Request demonstrations of products you will use. Once you have determined that a particular product or vendor is the right fit, ensure that you have a good sense of the total costs you will incur once you engage that vendor. Once you are comfortable with your selection of a vendor, consult with an attorney before signing any written agreement to ensure that you are protected for any potential issues that may occur (for example, if the vendor fails to provide the required services or is careless with patient data). Your attorney can also confirm whether these vendors are considered “Business Associates” under HIPAA, such that they would be required to enter into separate business associate agreements.
Cybersecurity Risks and Other Technological Issues. Telehealth services are subject to the same state and federal privacy laws to which in-person services are subject. Ensure that any wireless connections are secure, that your practice and staff are using best cybersecurity practices (such as strong passwords and multifactor authentication). Also confirm that your current internet services will be sufficient to provide telehealth services as needed, and consider what backups (such as hotspots) you can use in the event of a disruption. Make sure that your electronic medical record system can seamlessly integrate into your existing recordkeeping systems.
Consents. You should already have in place all relevant patient consents. However, you should ensure that you also have consents for any patient who is using telehealth services. An attorney can assist in drafting a consent, so that it complies with all relevant law and best practices to ensure that you and your practice is protected.
If you are interested in setting up telehealth services as part of your health care practice, please contact PK Law so we can assist you in navigating this framework.
Diva Bole is an Attorney in PK Law’s Corporate and Real Estate Group. She focuses her practice on business formation, mergers and acquisitions, joint ventures, commercial lending, financing and leasing, complex contracts, and corporate restructuring. Diva can be reached at 410-938-2645 or dbole@pklaw.com.
