COVID-19 Telehealth Toolkit to Accelerate State Use of Telehealth in Medicaid and CHIP

Author: Centers for Medicare & Medicaid Services (CMS)
Published: 2020/04/23 - Updated: 2023/01/08
Topic: Telemedicine or eHealth - Publications List

Page Content: Synopsis - Introduction - Main

Synopsis: This toolkit provides U.S. states with issues to consider as they evaluate the need to expand their telehealth capabilities and coverage policies. The toolkit will help states identify restrictions on telehealth eligibility, like only allowing coverage for beneficiaries who live in rural areas.

Introduction

The Trump Administration has just released a new toolkit for states to help accelerate the adoption of broader telehealth coverage policies in the Medicaid and Children's Health Insurance Programs (CHIP) during the 2019 Novel Coronavirus (COVID-19) pandemic. This release builds on the agency's swift actions to provide states with a wide range of tools and guidance to support their ability to care for their Medicaid and CHIP beneficiaries during this public health emergency.

Focus

Ensuring that patients can safely receive the care they need at home minimizes travel to healthcare facilities and supports efforts to limit the community's spread of the virus. Under President Trump's leadership, CMS has taken numerous steps to ensure that Americans can access the health care services they need through electronic and virtual means. Swift actions in Medicare have ensured that the nation's health coverage program for seniors can pay for telehealth services delivered nationwide and in any setting. Recent steps have expanded Medicare payment for 80 additional telehealth services.

Building on those actions, CMS provides this toolkit for states to take similar steps. The state and federal governments jointly administer Medicaid and CHIP programs and provide health coverage for over 71 million Americans, including 35 million children. Coverage and payment policies vary by state within federal parameters, and this toolkit will help states identify policies that may impede telehealth's rapid deployment when providing care. States enjoy broad federal flexibility to cover telehealth through Medicaid, including which methods of communication (such as telephonic and video technology commonly available on smartphones and other devices) a state may use.

"While not all patient interactions can be delivered through telehealth, our clinicians on the frontlines need every tool in their arsenal to fight this invisible enemy," said CMS Administrator Seema Verma. "I'm urging states to use this toolkit to make sure our Medicaid patients, particularly our children, can continue to receive needed care from the safety of their homes."

This toolkit provides states with issues to consider as they evaluate the need to expand their telehealth capabilities and coverage policies, including:

• Patient populations eligible for telehealth: Federal rules allow Medicaid services to be delivered via telehealth across all populations. The toolkit will help states identify restrictions on telehealth eligibility, like only allowing coverage for beneficiaries who live in rural areas.
• Coverage and reimbursement policies: While telehealth may not be appropriate for all services, states should review services even if they have not traditionally been delivered in such a manner. For example, some states may have only allowed behavioral health services to be delivered through telehealth. Medicaid reimbursement rates must also be adequate to facilitate care delivered through telehealth. Not all states have provided reimbursement parity with face-to-face encounters.
• Providers and practitioners eligible to provide telehealth: The toolkit will help states to evaluate whether state practice acts or regulations limit the ability of certain providers to deliver services through telehealth.
• Technology requirements: The dominant form of telehealth is generally thought of as two-way audio/visual communication or a video chat. However, telehealth is much broader than this since other forms have always existed alongside what some people consider standard telehealth, such as remote patient monitoring, etc.
• Pediatric considerations: Given the importance of Medicaid and CHIP to the pediatric population, the toolkit focuses on this group. For example, states should consider state consent and privacy laws in developing telehealth coverage policies for children.

The toolkit also includes a compilation of frequently asked questions (FAQs) and other resources available to states. This toolkit is the latest in a series of tools and checklists that CMS has released to help provide states with emergency flexibilities and resources that they need them during the 2019 Novel Coronavirus (COVID-19) outbreak.

This release and earlier CMS actions in response to the COVID-19 virus are all part of ongoing White House Coronavirus Task Force efforts. To keep up with the important work, the Task Force is doing in response to COVID-19, www.coronavirus.gov

For a complete and updated list of CMS actions, guidance, and other information in response to the COVID-19 virus, please visit the Current Emergencies Website.

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Attribution/Source(s): This quality-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Centers for Medicare & Medicaid Services (CMS) and published on 2020/04/23, this content may have been edited for style, clarity, or brevity. For further details or clarifications, Centers for Medicare & Medicaid Services (CMS) can be contacted at cms.gov NOTE: Disabled World does not provide any warranties or endorsements related to this article.