Telehealth Services Amid COVID-19 and Flexibility to Waive Co-pays, Coinsurance, and Deductibles.

On March 17, 2020, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a policy statement allowing physicians and other health healthcare practitioners flexibility to waive co-pays, coinsurance and/or deductibles (cost-sharing amounts) for the provision of telehealth services. Normally, the routine waiver or reduction of cost-sharing amounts can implicate various federal laws as well as state laws, i.e., Florida’s Patient Brokering Act, Anti-kick Statute, etc. However, the OIG has announced that it will ease federal restrictions to allow providers to waive and/or reduce cost-sharing amounts during the COVID-19 public health emergency; provided, that the following two conditions are met:

  • A physician or other practitioner reduces or waives cost-sharing obligations (i.e., coinsurance and deductibles) that a beneficiary may owe for telehealth services furnished consistent with the then-applicable coverage and payment rules.
  • The telehealth services are furnished during the time period subject to the COVID-19Declaration. See OIG policy statement, March 17, 2020.

Health care practitioners are cautioned to follow state and federal laws for the provision of telehealth services, including practicing in a manner consistent with the scope of practice and prevailing professional standards of practice.

Providers who are considering offering telehealth for the first time in response to the COVID-19 outbreak are encouraged to seek regulatory guidance and legal counsel as needed. For example, providers should consider revising their consent forms to allow for telehealth, revising or amending their privacy notices, as well as obtaining financial consent for electronic payment of cost-sharing obligations, if any. Moreover, providers must insure that they continue to maintain medical records as used for in-person services to properly document the patient encounters and ensure confidentiality.

The OIG policy statement intends to reduce patient financial barriers to telehealth services by allowing providers to waive cost-sharing obligations while also promoting telehealth to individuals seeking and/or needing medical services who are concerned with exposure to COVID-19 in the traditional office or hospital setting. See Office of Inspector General Fact Sheet March 2020.

With growing uncertainty about this virus, now is the time for health care providers to consider offering telehealth services. In order to start a telehealth model, providers should be mindful of necessary consent forms, evaluating telehealth vendors, the contractual obligations between a provider and a telehealth provider, and possibly seeking IT support.

If you need legal guidance preparing your practice for telehealth services and/or need to register as an out-of-state telehealth provider for rendering services to Florida residents; please do not hesitate to contact Mr. Rafael (Ralph) Gaitan, Esq., who is experienced in these matters. Mr. Gaitan can be reached at (786) 440-8115 or via email at [email protected].