The Trump administration has made sweeping changes to how the government covers and pays for telehealth services, adopting many measures the industry has spent years advocating for.
Medicare will now cover telehealth services for multiple provider types, allow patients to use services from any healthcare setting and even allow patients to receive treatment from their homes, according to a March 17 statement from the U.S. Centers for Medicare and Medicaid Services. The program will also cover services ranging from preventative care and virtual check-ins to mental health counseling.
The CMS said the policy updates are protecting a population at a higher risk for getting COVID-19, the respiratory disease caused by the coronavirus.
Telehealth primarily involves the remote delivery of healthcare, including connecting rural emergency rooms to specialists in hospitals hundreds of miles away and providing basic consultations through technology like a live-video feed.
Medicare is the government-run health insurance program for people 65 years or older, who have certain disabilities, or who have end-stage renal disease.
The payment and regulatory changes open up a Medicare program that was oftentimes unaccepting of telehealth. For example, the program previously only covered a limited number of services and restricted where a patient could receive them, which typically prevented at-home treatment.
Medicare would pay higher rates for a service if done in-person compared to when using telehealth technology, according to telehealth companies. That policy has now been changed. The CMS will also waive a policy that paid for telehealth in rural areas of the country but not urban areas, another move that had been advocated for by the telehealth industry.
All of the latest Medicare changes are in effect as of March 6 through the duration of the public health emergency, according to the CMS.
Shares of Teladoc Health Inc., a leading telehealth provider, jumped from $118.24 on March 17 to $136.93 at market close March 18. Like most companies, Teladoc has seen volatility in the markets as the coronavirus weighs on the broader economy but had previously seen its stock price on the rise from September 2019 through late February.
Telehealth usage climbing
The administration's sudden embrace of telehealth comes as hospitals and health systems across the country are seeing an increase in virtual care usage due to the outbreak. Hospitals have said patients' use of telehealth technology has helped ease increasing patient volumes, allowing doctors and nurses to focus on patients who need care the most.
At least 9,415 cases of COVID-19 have been confirmed in the U.S. and 150 deaths as of March 19, according to a tracker from Johns Hopkins University's Center for Systems Science and Engineering. A White House official said March 18 that the number of confirmed cases is expected to dramatically increase as more tests are conducted.
Shabana Khan, director of child and adolescent telepsychiatry for NYU Langone Health, an academic medical center in New York City, said the rules governing telehealth are "evolving minute by minute" now that the industry is getting national attention.
Khan, who has used telehealth technology for over 10 years, said NYU Langone Health has seen a significant increase in virtual urgent care usage and other specialty services. She expects the loosening of regulations to further drive usage.
"There is a lot of potential for us to use this technology in the context of an emergency," Khan said.
While some regulations are opening up federal programs like Medicare, state-specific regulations still need to be followed, according to Khan.
Both the Trump administration and Congress have eased telehealth regulations over the last few weeks. When Trump declared a national emergency March 13, he said the U.S. Department of Health and Human Services has the authority to waive telehealth laws as well. Congress also removed some Medicare restrictions as part of an $8.3 billion emergency spending bill signed by the president March 6.
These temporary removals of payment and policy restrictions may lead to more permanent changes after the outbreak, Khan said.