August 10, 2020

Volume X, Number 223

August 10, 2020

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COVID-19 – New York Expands Telehealth Utilization

We hope that everyone is staying safe during the COVID-19 crisis. State health departments are, of course, doing what they can to facilitate management of transmission of COVID-19 by healthcare providers. Some recent actions by the New York Department of Health (“DOH”) to allow or promote telephonic and telehealth services include:

Telephonic Evaluation – Beginning with dates of service of March 13, Medicaid will reimburse telephonic evaluation and management services for established patients where face-to-face visits may not be recommended and it is medically appropriate to evaluate and manage the patient by phone. Additionally, where a patient face-to-face visit is not possible due to the State of Emergency, telephonic visits documented as clinically appropriate by the provider will be considered medically necessary for Medicaid payment purposes.

Face to Face Requirements – DOH has authorized Home and Community Based Services provided under both the Home Health Care Management and 1915(c) Children’s Waiver to be provided telephonically or via telehealth whenever possible in lieu of face-to-face contact.   

Cost Sharing – For New York Medicaid Managed Care plans, the Medicaid program will cover services including testing for COVID–19 and for physician, clinic, and emergency visits without copays for members when the purpose of the visit is testing for COVID–19. New York State Department of Health, New York State Medicaid Update, March 2020 Special Edition – COVID-19 (Mar. 10, 2020).

Telehealth – Also for New York Medicaid Managed Care plans, under prior amendments to the New York Insurance and Public Health Laws, services that are covered under a comprehensive health insurance policy or contract must be covered when the service is delivered via telehealth. DOH is encouraging the use of telehealth modalities to provide COVID–19 related services to Medicaid recipients. More information on the current telehealth policy can be found in the February 2019 Medicaid Update hereNew York State Department of Health, New York State Medicaid Update, March 2020 Special Edition – COVID-19 (Mar. 10, 2020).

Medicaid Special Editions can be found at https://www.health.ny.gov/health_care/medicaid/program/update/2020/index.htm

For information on telehealth for Medicare beneficiaries, see the previously published post: Congress’s COVID-19 Funding Legislation Expands Access to Telehealth Services for Medicare Beneficiaries.

©2020 Epstein Becker & Green, P.C. All rights reserved.National Law Review, Volume X, Number 78

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About this Author

Arthur J. Fried, Health Care, Life Sciences, Attorney, Epstein Becker, Law firm
Member

ARTHUR J. FRIED is a Member of the Firm in the Health Care and Life Sciences practice, in the firm's New York office. He represents all types of health care providers, including academic medical centers, hospitals, and faculty practices.

Mr. Fried:

  • Advises hospitals, academic medical centers, and other providers in such areas as strategic health system development, physician integration, health care reform, medical staff matters, and governance

  • Provides advice on...

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AMY F LERMAN regulatory transactional health care lawyer Epstein Becker Law firm
Member

AMY F. LERMAN is an Associate in the Health Care and Life Sciences practice, in the Washington, DC, office of Epstein Becker Green. Ms. Lerman focuses her practice on a variety of regulatory and transactional health care matters, including corporate compliance, durable medical equipment, Medicare program integrity auditing and monitoring, and telehealth/telemedicine. She represents a variety of health care providers and organizations, as well as investors and other financial institutions that invest in or support the health care industry.

Ms. Lerman:

  • Assists and advises clients in connection with government investigations relating to health care fraud and abuse
  • Counsels clients in the areas of federal and state fraud issues including anti-kickback, self-referral, false claims, and false billings
  • Advises clients on legal, regulatory, and reimbursement matters arising under the Medicare, Medicaid, and other third-party reimbursement programs
  • Assists clients in evaluating, developing, and implementing health care corporate compliance programs
  • Advises investors and other financial institutions that invest in or support the health care and life sciences industries
  • Advises health providers and health-related companies, financial institutions, and investors of industry trends and policy developments
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