Today, the Department of Health and Human Services’ Office for Civil Rights (OCR) issued guidance on HIPAA requirements as they relate to audio-only telehealth. Importantly, for the first time, OCR provides insights on its position on the difference between landline and VoIP telecommunication services. OCR’s guidance applies now and after its telehealth enforcement discretion is […]
In my July 23, 2020 blog post, I used the familiar characters in the beloved fable The Three Little Pigs to illustrate the importance of building a secure and compliant telehealth delivery system. I explained that, despite the Office for Civil Rights’ (OCR) announcement of enforcement discretion during the public health emergency (PHE), healthcare providers should establish HIPAA-compliant telehealth delivery systems before enforcement discretion ended. Because the PHE may soon be over, that message bears repeating.
Early in the COVID-19 pandemic, Governor Ned Lamont expanded the use of telehealth for Medicaid-enrolled providers and in-network providers through various executive orders (G, DD and FF (collectively, the “Telehealth Executive Orders”)). That expansion included permitting the use of audio-only (telephone) delivery of telehealth services. On Friday, July 31, 2020, the Governor signed legislation, An Act Concerning Telehealth, that codified many of the provisions in the Telehealth Executive Orders through March 15, 2021.
We learned early in life from the Three Little Pigs that a house made of straw or sticks, while much easier to build, lacks the safety and security of a brick house. This fable’s lesson applies to many scenarios including the recent rapid deployment of telehealth services. While a pandemic, not laziness, caused the hurried telehealth services implementation for many, that’s irrelevant to the big bad wolf (and there is always a big bad wolf). He will come and he will huff, and he will puff, and he will compromise the privacy of patient information in a system without adequate protections.
Until recently, telehealth was not commonplace here in CT. Not only has the public health emergency forced widespread adoption of telehealth, but it also triggered a flurry of piecemeal rules and executive orders in rapid-fire succession causing substantial confusion. The most confusing of those rules relate to the delivery of telehealth services via telephone.
Keeping track of the flurry of rules and changes related to telehealth during this COVID-19 public health emergency has been challenging. I offer the timeline below as a resource with links to all the underlying sources. I will update this timeline as changes come about.
Yesterday, Connecticut’s Commissioner of Public Health issued an order suspending licensure requirements for certain healthcare providers licensed in other states for a period of 60 days. This order continues to expand access to telehealth opportunities as out of state providers can now provide telehealth services to Connecticut residents.
Late Friday, the Office for Civil Rights (OCR) issued FAQs on telehealth and HIPAA as a follow up to DHHS’ announcement that OCR would use “enforcement discretion” for HIPAA non-compliance related to the good faith roll out of telehealth services during the COVID-19 emergency. The FAQs provide useful information about the types of applications that can be used for telehealth as well as examples of bad faith conduct.
By executive order late yesterday, Governor Ned Lamont expanded permission to offer “audio-only” telehealth services to commercial insurer’s in-network providers furnishing covered telehealth services. Two days ago, the Governor granted this permission to Medicaid providers serving Medicaid beneficiaries. The Executive Order also addresses licensure and location requirements and conditions for other providers wishing to offer telehealth services. Additionally, the order assures providers that compliance with federal agency guidance on HIPAA is adequate to meet state law.
Just one week ago, Medicaid in Connecticut did not cover telehealth services. Then, DSS issued Provider Bulletins 2020-09 and 2020-10 providing for emergency temporary telehealth coverage in response to the Covid-19 pandemic. Today, the Connecticut Department of Social Services (DSS) issued Provider Bulletin 2020-14, which further expands Medicaid reimbursement to include telehealth delivered via telephone.