August 2, 2021

HHS has extended the federal public health emergency (PHE) for an additional 90 days through October 20, 2021.  At this time, it appears likely that the federal PHE will remain in effect at least for the duration of 2021, if not longer. HHS has indicated that it will provide at least 60 days’ notice of any change.

On July 13, 2021, the Centers for Medicare and Medicaid Services (CMS) issued a proposed Medicare rule for calendar year 2022. This rule includes the following proposals relating to telehealth services covered by Medicare:

1. During the federal PHE, CMS added the home as a permissible originating site. At this time, CMS is proposing to continue to permit the provision of telehealth services to Medicare beneficiaries in their homes, but would require one in-person, non-telehealth service to be provided within the six (6) months prior to the telehealth visit and at least once every six (6) months thereafter.  National and state advocates (including the NYS Council) are working to compel CMS to repeal the ‘once every 6 months’ requirement. 
2. CMS is proposing to permanently permit audio-only communication for the diagnosis, evaluation, or treatment of mental health disorders provided to established patients at home, if the patient is unable to use, does not wish to use, or does not have access to two-way, audio/video technology. CMS intends to establish a new modifier for audio-only services to indicate that the provider had the capacity to furnish a two-way audio/video telehealth service, but utilized audio-only technology instead as a result of patient choice or other technological limitations.  

Remember:  The Medicare Program is overseen by the federal government.  The NYS Medicaid Program is largely overseen by the Department of Health. Locus of control matters and helpful to keep in mind when trying to decipher the meaning of various guidance documents.

If you have questions, please feel free to reach out to me at 518 461-8200 at your convenience.