On February 4, 2021, the Department of Justice (“DOJ”), Office of Public Affairs, issued a Press Release (the “DOJ Press Release”) announcing that Kelly Wolfe, President of Regency, Inc., a medical billing company located in Florida, pleaded guilty to conspiracy to commit healthcare fraud through a “pernicious telefraud scheme”[1] involving fraudulent Medicare and CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs) claims for medically unnecessary durable medical equipment (“DME”) supplies.  As a result of Wolfe’s criminal plea, Wolfe could face up to 13 years in federal prison. 
Continue Reading OIG Warns Telehealth Industry: “With Great Power Comes Great Responsibility”

West Virginia Bill Seeks to Regulate Parity and Out-of-State Providers

On February 10, 2021, members of the West Virginia Legislature introduced Senate Bill 1 (“SB1”) which seeks to regulate the use of telemedicine in the state. If passed, the proposed bill would require the Public Employees Insurance Agency, Medicaid and specified insurance plans to cover telehealth services at the same rate as in-person healthcare, starting July 1, 2021. The bill would also permit healthcare providers who are licensed in other states to provide telehealth services in West Virginia.
Continue Reading The “State” of Telehealth: West Virginia

Washington State Seeks to Make Audio-Only Telehealth Permanent

On February 5, 2021, Washington State Rep. Marcus Riccelli introduced House Bill 1196 (“HB-1196”) which seeks to set specific guidelines for use and coverage of audio-only telehealth platforms, such as the phone. HB-1196 would mandate coverage for audio-only telehealth beyond the public health emergency (the “Pandemic”) as long as the service met certain requirements. The bill was passed almost unanimously by the House on February 24, 2021 and is now before the state Senate.
Continue Reading The “State” of Telehealth: Washington

Oregon Telehealth Bill Proposes Parity for Telehealth Services

On January 11, 2021, Oregon Senator Lee Beyer and Rep. Rachel Prusak, introduced Senate Bill 11 (“SB11”)[1], which would permanently extend parity for telehealth services with in-clinic care services. Parity for telehealth services was originally proposed in response to Governor Kate Brown’s March 23, 2020 Executive Order 20-22 which ordered a temporary halt on nonurgent procedures to preserve personal protective gear for frontline workers. Telehealth services provided clinical providers with an opportunity to maintain revenue by allowing individuals to seek care from the safety of their own homes. In line with the move to telehealth services, emergency payment policies enacted by the Oregon Department of Consumer and Business Services and payers’ voluntary agreement allowed providers to receive the same rates for telemedicine services as they would for in-clinic services.
Continue Reading The “State” of Telehealth: Oregon

Telehealth services and providers have been in high demand as the world copes with the COVID-19 public health emergency.  Federal and state agencies have amended, and often loosened, regulations in an attempt to facilitate and expand access to telehealth.  However, the honeymoon phase of relaxed oversight may be coming to an end as the world adjusts to a new-normal.
Continue Reading The Honeymoon Phase Is Over: OIG to Audit COVID-19 Part B Telehealth Services

Texas Governor Wants to Make Permanent Changes to Telemedicine Access

As part of his 2021 of the State address, Texas Governor, Greg Abbott, introduced his intention to permanently expand telemedicine services that were made available during the COVID-19 public health emergency (the “Pandemic”).
Continue Reading The “State” of Telehealth: Texas

New Hampshire Seeks to End Telehealth Parity and Audio-Only Phone Coverage

On January 13, 2021, New Hampshire lawmakers, Jess Edwards, Jason Osborne and John Hunt, introduced House Bill 602, which seeks to roll back certain provisions of the July 21, 2020 telehealth bill (“House Bill 1623”) signed into law by Governor Chris Sununu, during the height of the COVID-19 public health emergency (the “Pandemic”). House Bill 1623, amended the state’s definition of telemedicine to include new modalities, including audio-only phones, and requires Medicaid and private payers to reimburse for telehealth services on the same basis that it reimburses for in-person care. In sharp contrast, the newly proposed House Bill 602 would revise the state’s telehealth rules to eliminate payment parity and coverage for audio-only services.
Continue Reading “State” of Telehealth Series: New Hampshire

In response to the ongoing COVID-19 public health emergency (the “PHE”) first declared on March 13, 2020, the Centers for Medicare & Medicaid Services (“CMS”) issued blanket Section 1135 Waivers to expand, albeit on a temporary basis during the PHE, the range of healthcare professionals who can provide Medicare-covered telehealth services to include physical therapists, occupational therapists, speech language pathologists, and other non-physician practitioners.  (See also, CMS Fact Sheet, “Medicare Telemedicine Health Care Provider Fact Sheet” (March 17, 2020) and CMS’s “COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers” (December 1, 2020)).
Continue Reading The Other Shoe Drops: OIG To Audit COVID-19 Telehealth Home Health Services

New York Telehealth Reforms – 2021 and Beyond

The Empire State continues its expansion of telehealth adoption as Governor Andrew Cuomo introduced a number of proposals as part of his 2021 State of the State agenda set to “permanently adopt COVID-19-era innovations” in telehealth.  The proposals are part of a wave of proposed legislation meant to cement the changes in telehealth regulation necessitated by the COVID-19 pandemic (the “Pandemic”). Building on New York State’s adoption of Senate Bill S8416 over the summer which had already made a permanent change in the expanded definition of telehealth to include audio-only telephone communication, if adopted the proposal would provide licensing reciprocity in certain specialties, as well as remove traditional prerequisites to the provision of telehealth.
Continue Reading “State” of Telehealth Series: New York

This week, Rep. Mike Thompson (CA-05), founder and co-chair of the Congressional Telehealth Caucus reintroduced the Protecting Access to Post-Covid-19 Telehealth Act of 2020 (the “Act”) with support from Co-Chairs Rep. Peter Welch (VT-AL), Rep. Bill Johnson (OH-06), and Rep. David Schweikert (AZ-06) and caucus member Rep. Doris Matsui (CA-06).  The Act was originally introduced in the House of Representatives on July 16, 2020. The focus of the Act is to do away with certain restrictions on providing telehealth services, and to permanently expand coverage for telehealth services both during and beyond the COVID-19 Pandemic. Among other things, the Act:
Continue Reading Re-Introducing the Protecting Access to Post-Covid-19 Telehealth Act