Although available, telehealth didn’t become commonplace until the throes of the pandemic. Technology, availability, payment codes, and other solutions were rapidly implemented. Now that the PHE is officially over, where does that leave HIPAA compliant telehealth?
Telehealth reduced infection risk, expanded critical access to care for all types of communities, and addressed capacity challenges. The official PHE declaration also enabled providers to bill Medicare for telehealth services regardless of location, prescribe controlled substances via telehealth, and use waivers for telehealth reimbursement and other flexibilities.
Permanent and Temporary Changes
Some of these are temporary and will expire when the PHE and extensions completely end. The PHE was last renewed on Jan. 7, 2023 and was effective until Apr. 21, 2023. Congress extended some telehealth services for five months beyond the end of the PHE in the Consolidated Appropriations Act, 2023.
Some of the permanent changes that will not go away include:
- Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) can serve as a distant site provider for behavioral/mental telehealth services.
- Medicare patients can receive telehealth services for behavioral/mental health care in their home.
- There are no geographic restrictions for originating site for behavioral/mental telehealth services.
- Behavioral/mental telehealth services can be delivered using audio-only communication platforms.
- Rural Emergency Hospitals (REHs) are eligible originating sites for telehealth.
Some of the temporary changes that are set to expire after December 31, 2024 include:
- FQHCs and RHCs can serve as a distant site provider for non-behavioral/mental telehealth services.
- Medicare patients can receive telehealth services in their home.
- There are no geographic restrictions for originating site for non-behavioral/mental telehealth services.
- Some non-behavioral/mental telehealth services can be delivered using audio-only communication platforms.
- An in-person visit within six months of an initial behavioral/mental telehealth service, and annually thereafter, is not required.
Telehealth services can be provided by all eligible Medicare providers.
HIPAA Compliant Telehealth
During the PHE, the HHS Office for Civil Rights announced that it would not impose penalties for noncompliance with HIPAA rules concerning telehealth and RPM.
As of April 11, 2023, covered health care providers will need to comply with the HIPAA Rules when providing telehealth to ensure PHI is handled in a private and secure manner. The Office for Civil Rights (OCR) at HHS is providing a 90-calendar day transition period for covered health care providers after May 11, 2023 to make any changes to their operations that are needed to provide telehealth in compliance with the HIPAA Rules.
Some of the items that may need to be corrected to ensure HIPAA compliance with telehealth and RCM are:
- Securing the connection between the provider and the patient using encryption, firewalls, VPNs, and other safeguards.
- Authenticating the users who access PHI using passwords, PINs, biometrics, or other methods.
- Logging off automatically from telehealth platforms or applications after each session or after a period of inactivity.
- Signing a business associate agreement (BAA) with any third-party service providers that handle PHI on behalf of the covered entity.
- Implementing policies and procedures for telehealth services that address privacy, security, consent, documentation, and quality standards.
- Training staff on how to use telehealth platforms or applications in a HIPAA-compliant manner and how to report any breaches or incidents.
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