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Policy changes during the COVID-19 Public Health Emergency

The federal government has taken concrete steps to make telehealth services easier to implement and access during this national emergency. These changes are temporary measures during the COVID-19 Public Health Emergency and are subject to revision. Here are some of the highlights.

The U.S. Department of Health and Human Services Office for Civil Rights issued a Notification of Enforcement Discretion to empower covered health care providers to use widely available communications applications without the risk of penalties imposed by the U.S. Department of Health and Human Services Office for Civil Rights for violations of Health Insurance Portability and Accountability Act of 1996 (HIPAA) rules for the good faith provision of telehealth services. For more information, read FAQs on Telehealth and HIPAA during the COVID-19 nationwide public health emergency (PDF) or visit HIPAA and COVID-19.

Under this notice, covered health care providers may use popular applications to deliver telehealth as long as they are “non-public facing”. Examples of public facing applications are Facebook Live, Twitch, and TikTok.

Examples of non-public facing video chat applications include:

  • Apple FaceTime
  • Facebook Messenger video chat
  • Google Hangouts video
  • Zoom
  • Skype

Examples of non-public facing text-based applications include:

  • Signal
  • Jabber
  • Facebook Messenger
  • Google Hangouts
  • WhatsApp
  • iMessage

Under this notice, covered health care providers that seek additional privacy protections should use technology vendors that are HIPAA compliant and will enter into HIPAA business associate agreements in connection with the provision of their video communication products. The list below includes some vendors that say they provide HIPAA-compliant video communication products and that they will enter into a HIPAA business associate agreement.

  • Skype for Business / Microsoft Teams
  • Updox
  • VSee
  • Zoom for Healthcare
  • Doxy.me
  • Google G Suite Hangouts Meet
  • Cisco Webex Meetings / Webex Teams
  • Amazon Chime
  • GoToMeeting
  • Spruce Health Care Messenger

Note: The U.S. Department of Health and Human Services Office for Civil Rights has not reviewed the business associate agreements offered by these vendors, and this list does not constitute an endorsement, certification, or recommendation of specific technology, software, applications, or products. There may be other technology vendors that offer HIPAA-compliant video communication products that will enter into a HIPAA business associate agreement with a covered entity. Further, the U.S. Department of Health and Human Services Office for Civil Rights does not endorse any of the applications that allow for video chats listed above.

Disclaimer: The reference to named video- and text-based communications software for telehealth is informational and not intended as an endorsement of those services.

The Centers for Medicare & Medicaid Services is making it easier for patients enrolled in Medicare to receive medical care using telehealth technology.

Patient location

Health care providers may offer telehealth services to patients located in their homes and outside of designated rural areas.

For the duration of the COVID-19 Public Health Emergency, the Centers for Medicare & Medicaid Services will reimburse telehealth visits in lieu of many in-person appointments.

Practicing across state lines

The Centers for Medicare & Medicaid Services announced a waiver allowing doctors to furnish telehealth and other services using communications technology wherever the patient is located, including at home, even across state lines.

However, practicing across state lines is subject to requirements set by the states involved. The Federation of State Medical Boards provides a list of the states waiving in-state licensure requirements exit disclaimer icon (PDF) for telehealth in response to the COVID-19 Public Health Emergency.

Relationship between patient and provider

During the COVID-19 Public Health Emergency, physicians may see both new and established patients for telehealth and other visits furnished using communications technology.

Types of telehealth services covered

The Centers for Medicare & Medicaid Services significantly expanded the list of services that can be provided by telehealth during the COVID-19 Public Health Emergency. Some types of telehealth services no longer require both audio and video — visits can be conducted over the telephone. See this list of telehealth services for details.

Types of eligible providers

Generally, any provider who is eligible to bill Medicare for their professional services is eligible to bill for telehealth during this period.

Supervision of physicians

Physicians may supervise services through audio and video communication, instead of only in-person.

For more information about these Medicare policy changes, refer to:

During the COVID-19 Public Health Emergency, Federally Qualified Health Centers and Rural Health Clinics can provide telehealth services to patients wherever they are located, including in their homes. This includes coverage of certain audio-only telephone evaluation and management services. For more information, refer to:

The Drug Enforcement Administration has made 2 changes related to prescribing controlled substances during the COVID-19 Public Health Emergency.

  • A practitioner can prescribe a controlled substance to a patient using telemedicine, even if the patient isn’t at a hospital or clinic registered with the DEA
  • Qualifying practitioners can prescribe buprenorphine to new and existing patients with opioid use disorder based on a telephone evaluation

For more on the specific requirements for practitioners, see:

Health care providers won’t face administrative sanctions for reducing or waiving any cost-sharing obligations for telehealth services paid for by federal or state health care programs, such as Medicare and Medicaid.

For more information, refer to:

Last updated: July 7, 2020