By Christopher Cole

Law360 (March 17, 2020, 7:35 PM EDT) -- The federal agency that runs Medicare said Tuesday it was vastly expanding use of telehealth services under the medical program for older Americans, who make up the demographic most at risk for illness from the novel coronavirus.

The Centers for Medicare & Medicaid Services said the move was part of the White House coronavirus task force's response to the disease outbreak. Since social distancing underpins efforts to contain the virus, the government is encouraging people to stay home, especially vulnerable groups.

The expanded Medicare coverage will enable beneficiaries to receive a wider range of health care services from their doctors without having to travel to a facility. The move follows similar federal efforts to increase telehealth use, including the Federal Communications Commission expanding connectivity funds for rural hospitals to use such services.

Medicare will temporarily pay clinicians to provide telehealth for beneficiaries residing across the entire country, for services March 6 and after.

"These changes allow seniors to communicate with their doctors without having to travel to a health care facility so that they can limit risk of exposure and spread of this virus," CMS Administrator Seema Verma said in a Tuesday statement. "Clinicians on the front lines will now have greater flexibility to safely treat our beneficiaries."

The CMS action occurs four days after President Donald Trump announced a national emergency under the Stafford Act and the National Emergencies Act due to the spread of COVID-19. The agency can expand Medicare's telehealth benefits under what's called its 1135 waiver authority, and the coronavirus supplemental spending act.

CMS said its guidance and other recent actions by CMS provide "regulatory flexibility" to ensure that all Americans, particularly high-risk individuals, are aware of easy-to-use, accessible benefits that can help keep them healthy while helping to contain the coronavirus.

Previously, Medicare was only allowed to pay clinicians for telehealth services such as routine visits in certain circumstances, such as getting telehealth services from a doctor in a remote location, and the beneficiary generally couldn't get telehealth services in their home.

Under the new policy, a range of providers including doctors, nurse practitioners, clinical psychologists and licensed clinical social workers, will be able to offer telehealth to Medicare beneficiaries, CMS said. Beneficiaries will be able to receive telehealth services not only from home but in any health care facility, including a physician's office, hospital, nursing home or rural health clinic. The policy covers a range of services from common office visits to mental health counseling and preventive health screenings.

"This change broadens telehealth flexibility without regard to the diagnosis of the beneficiary, because at this critical point it is important to ensure beneficiaries are following guidance from the CDC including practicing social distancing to reduce the risk of COVID-19 transmission," the Medicare agency said.

Trump has also called on private insurers to expand and clarify their policies around telehealth.

CMS' move comes as its parent agency, the U.S. Department of Health and Human Services, takes steps to make it easier for providers to communicate with patients about coronavirus without facing penalties for running afoul of strict privacy rules under the Health Insurance Portability and Accountability Act.

HHS Secretary Alex Azar has exercised authority to waive sanctions and penalties against a covered hospital that does not comply with the certain provisions of HIPAA, including requirements to obtain a patient's agreement to speak with family members or friends involved in the patient's care.

And a new policy, unveiled by the department's Office of Civil Rights, deals with the fact that during the nationwide public health emergency, providers subject to the HIPAA rules may seek to communicate with patients and provide telehealth through remote communications technology.

"Some of these technologies, and the manner in which they are used by HIPAA-covered health care providers, may not fully comply with the requirements of the HIPAA rules," the office said.

"OCR will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency," the office said in a notice.

That enforcement discretion was effective immediately.

Also Tuesday, the HHS Office of Inspector General told physicians and other practitioners that they will not be subject to administrative sanctions for reducing or waiving any cost-sharing obligations federal health care program beneficiaries may owe for telehealth services.

The policy has two main conditions: the services must be furnished consistent with applicable coverage and payment rules, and only during the COVID-19 public health emergency declaration period.

--Additional reporting by Kelcee Griffis and Jeff Overley. Editing by Orlando Lorenzo.

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