DOH Permits Use Of Telehealth For Prescribing Controlled Substance For Existing Patients During Emergency Declaration
For purposes of preparing for, responding to, and mitigating any effect of COVID-19, physicians, osteopathic physicians, physician assistants, and advanced practice registered nurses licensed in Florida that have designated themselves as a controlled substance prescribing practitioner pursuant to section 456.44, may issue a renewal prescription for a controlled substance listed as Schedule II, Schedule III, or Schedule IV under chapter 893 only for an existing patient for the purpose of treating chronic nonmalignant pain without the need to conduct a physical examination of the patient. These practitioners may only substitute telehealth services for the physical examination. Telehealth shall have the same meaning as section 456.47(1)(a). All other minimum practice requirements and standards of care shall still apply to renewal prescriptions issued under this exception. This exception shall only apply for a period not to exceed thirty days unless extended by order of the State Surgeon General. Any statute and/or rule to the contrary is hereby suspended for a period of thirty days, unless extended.
Click here for the full DOH Declaration.
CMS CHANGES TO TELEHEALTH, VIRTUAL SERVICES AND TELEPHONE CALL-BASED VISITS
At President Trump’s direction, the Centers for Medicare & Medicaid Services (CMS) is issuing an unprecedented array of temporary regulatory waivers and new rules to equip the American healthcare system with maximum flexibility to respond to the 2019 Novel Coronavirus (COVID-19) pandemic.
Watch our updated webinar in partnership with Acevedo Consulting regarding the changes announced on March 30, 2020.
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Healthcare insurers have announced the opening up of telehealth for network physicians at the normal in-person office visit rate. Please see the below news releases for details from some of the major insurers
Centers for Medicare and Medicaid Services
CMS Telehealth Fact Sheet
Blue Cross and Blue Shield of Florida
Florida Blue COVID-19 Update
CIGNA CORONAVIRUS (COVID-19) INTERIM BILLING GUIDANCE FOR PROVIDERS
UHC Actions to Support Providers During COVID-19 National Emergency
UHC COVID-19 Diagnosis Coding and Reimbursement Update
UHC Offers Special Enrollment and Reduces Administrative Requirements to Improve Access to Care and Coverage
Aetna Telemedicine and Direct Patient Contact Information
HHS Office of Civil Rights Enforcement Discretion related to HIPAA - update
Early last week, the Office for Civil Rights (OCR) notified covered entities, including physicians, that it would exercise enforcement discretion for physicians using telehealth. OCR has issued new FAQs on this notice, which we wanted to bring to your attention. Additionally, SAMHSA has issued a FAQ on 42 CFR Part 2, seeking to ensure that substance use disorder treatment services are uninterrupted during this public health emergency.
Sent:Tuesday, March 17, 2020 1:09 PM
Subject:HHS Office of Civil Rights Enforcement Discretion related to HIPAA
In light of the COVID-19 nationwide public health emergency, the HHS Office for Civil Rights (OCR) is exercising its enforcement discretion and, effective immediately, will not impose penalties on physicians using telehealth in the event of noncompliance with the regulatory requirements under the Health Insurance Portability and Accountability Act (HIPAA).
Physicians may seek to communicate with patients and provide telehealth services through remote communications technologies. Some of these technologies, and their use, may not fully comply with the requirements of the HIPAA Rules.
However, today’s announcement means that physicians who want to use audio or video communication technology to provide telehealth to patients during the COVID-19 nationwide public health emergency can use any non-public facing service that is available to communicate with patients. This exercise of discretion applies to telehealth provided for any reason, regardless of whether the telehealth service is related to the diagnosis and treatment of health conditions related to COVID-19.
For example, a physician using their professional judgement may request to examine a patient exhibiting COVID-19 symptoms, using a video chat application connecting the physician’s or patient’s phone or desktop computer in order to assess a greater number of patients while limiting the risk of infection of other persons who would be exposed from an in-person consultation. Likewise, a physician may provide similar telehealth services in the exercise of their professional judgment to assess or treat any other medical condition, even if not related to COVID-19, such as a sprained ankle, dental consultation or psychological evaluation, or other conditions.
Under this Notice, physicians may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype to provide telehealth without risk that OCR might seek to impose a penalty for noncompliance with the HIPAA Rules. Physicians should not use Facebook Live, Twitch, TikTok or other public facing communication services. Physicians are encouraged, but not required, to notify patients of the potential security risks of using these services and to seek additional privacy protections by entering into HIPAA business associate agreements (BAA). HHS also noted that while it hasn’t confirmed such statements, Skype for Business, Updox, VSee, Zoom for Healthcare, Doxy.me, and Google G Suite Hangouts have said that their products will help physicians comply with HIPAA and that they will enter into a HIPAA BAA.
Additional information can be found at this notice from Department of Health and Human Services (HHS).
Source: American Medical Association | AMA
TELEMEDICINE VENDOR OPTIONS
The following list provided by the Texas Medical Association reveals the key functionality of the various telemedicine products as reported by the vendors on their own websites. TMA has not vetted these companies but wanted to provide information for physicians seeking to implement telemedicine into their practice. This list is not exhaustive and is separated by companies offering stand-alone products and those that have electronic health record (EHR) integrations. Be sure to execute a business associate agreement with the telemedicine vendor.
ADDITIONAL TELEHEALTH OPTIONS
Info for dea-registered physicians
The U.S. Drug Enforcement Administration (DEA) issued guidance to DEA-registered physicians providing new flexibility for physicians managing patients with opioid use disorder. The new guidance permits physicians and other health professionals with a waiver allowing them to prescribe buprenorphine for the treatment of opioid use disorder to issue these prescriptions to new and existing patients based on an evaluation via telephone. The new policy is effective from March 31 for the duration of the COVID-19 emergency.
11 Technical Tips for Telehealth