The SCMA will continue updating telehealth resources below There are new options everyday as Medicare, Medicaid, and private insurance carriers continue to open telehealth resources. 

Still struggling with telehealth?

Visit the AMA website geared to give you all of the information you need. The AMA has created a quick guide to Telemedicine in Practice along with FAQs on COVID-19 and Telemedicine. Click here to access. The AMA also has outlined coding scenarios designed to assist in coding practices. The AMA Physician Innovation Network launched a virtual panel on the use of Telemedicine to deliver care to those who need it most during COVID-19. They are taking questions related to the latest policy & payment updates, best practices and tips from experts and peers. Click here to join the AMA's virtual panel discussion.  Also, the AMA has started a COVID-19 (2019 novel coronavirus) resource center for physicians.

Most providers are now following the examples set by Medicare and Medicaid and allowing Skype and FaceTime rather than requiring special telehealth programs. Check with your providers for updates on their policies as most private insurance companies are now allowing this. 

If you are still looking for help gaining access to telehealth codes, the Department of Insurance is providing a page with the appropriate information of what each private insurer will cover linked here.  The details are provided under each company heading, and you can click the company heading to reach even more information.  

Medicare has a page devoted to COVID-19 waivers.  The page lists special fact sheets for each practice area, located here. Medicare has also provided a summary of all of the waivers in one document that can be found here. The CMS fact sheet on telehealth can be found here.  

The South Carolina Department of Health and Human Services (SC DHHS) has issued a Medicaid Bulletin with all of its telemedicine codes, which you can access here. 

The Health and Human Services (HHS) Office for Civil Rights (OCR) announced it will “waive potential penalties for HIPAA violations against health care providers that serve patients through everyday communications technologies during the COVID-19 nationwide public health emergency.”  This is effective immediately, and applies to “widely available communications apps, such as FaceTime or Skype, when used in good faith for any telehealth treatment or diagnostic purpose, regardless of whether the telehealth service is directly related to COVID-19.”  For more information, click here. 

The Office of Inspector General (OIG) issued a Policy Statement to notify physicians and other practitioners that they will not be subject to administrative sanctions for reducing or waiving any cost-sharing obligations related to telehealth. You can read the statement here.

• The free website Doxy.me has a free telehealth platform that can be used immediately with same day service. 
• CompuGroup Medical, your local Software-Provider from Columbia (SC), teamed up with the SCMA to give you its telemedicine services free for 6 months. Call CGM’s Telemedicine hotline at 602-680-2255 or fill out the contact form from the following linked here.
• The NC Medical Society launched a telemedicine platform branded as "Presence". Presence will be made available to all health care providers until the pandemic is over/90 days at no charge and is linked here. 

If you are a small business or solo proprietorship, you should know that the CARES Act creates a new Business Loan Program under the Small Business Act (SBA). Quick facts to see if this may assist your business short term:

• Between February 15, 2020 to June 30, 2020 the SBA is providing 100% federally-backed loans up to a maximum amount to eligible businesses to help pay operational costs like payroll, rent, health benefits, insurance premiums, utilities, etc.
• Sole proprietors, independent contractors, and eligible self-employed individuals are included in these loans.
• Subject to certain conditions, loan amounts are forgivable (see more detailed discussion on loan forgiveness below).
• Business are presumed to qualify for complete payment deferment relief (for principal, interest, and fees) for six months to one year.
• The loan can be forgiven (and excluded from gross income) in an amount equal to the following costs incurred and payments made during the covered period: payroll; interest payments on mortgages; rent; and utility payments.
• If an employer reduces the number of employees in the period, but fills these spots back by June 30, 2020, the employer can still qualify for the loan forgiveness. 

The CARES Act waives the 10% additional tax for premature distributions from retirement plans and IRAs if the distribution is related to COVID-19 with a maximum distribution of $100,000 from all plans.  Distributions may be repaid at any time over the next three years, beginning on the date the distribution was made.  This distribution provision applies to those diagnosed with SARS-CoV-2 or COVID-19 by a test approved by the Centers for Disease Control (CDC), their spouse or dependent who has been diagnosed by such a test, or a person who experiences adverse financial consequences as a result of being quarantined, furloughed, laid off, or suffered reduced working hours, or who is unable to work due to lack of child care. 

The CARES Act provides eligible employers – including tax-exempt organizations – a refundable credit against payroll tax (Social Security and Railroad Retirement) liability equal to 50% of the first $10,000 in wages per employee (including value of health plan benefits).  In order to qualify, you must have had business operations fully or partially suspended due to orders from a governmental entity limiting commerce, travel, or group meetings; or experience a year-over-year (comparing calendar quarters) reduction in gross receipts of at least 50%. 

$100 billion is available through the Public Health and Social Services Emergency Fund to provide immediate financial relief by covering non-reimbursable expenses attributable to COVID-19. Health care entities, including physician practices, that provide health care, diagnoses, or testing are eligible. Non-reimbursable expenses may include lost revenue due to COVID-19. HHS is reviewing applications and making payments on a rolling basis.  HHS will be releasing guidance soon on the application process, which we will provide in a MedNews once posted.

The CARES Act has a provision to allow an additional $600/week for up to four months and additional 13 weeks of Unemployment benefits for states that choose to participate. States can also enter agreements with the federal government to receive funding for state-enacted “short-time compensation” programs to subsidize employees who have their hours reduced in lieu of a layoff. 

The Families First Coronavirus Response Act (FFCRA) takes effect April 1, 2020 and provides new types of leave for employees. The FFCRA applies to employers with less than 500 employees. Employers may claim an exemption if they have less than 50 employees, but employers must document why providing such leave will jeopardize your business. The Department of Labor has yet to set forth the criteria for documenting this, but has promised guidance is forthcoming.  The Department of Labor issued  Guidance and FAQs on the new law. Also, there is a mandatory poster employers must hang in their office, found here.  Read below for the key provisions.

1. Exception for Health Care Providers and Emergency Responders -   An employer can choose to exempt employees who are health care providers or emergency responders from receiving such leave.  But this does not mean that every person in a health care facility receives the exemption. The definitions are specific, click here for a great legal article explaining who is  a qualifying health care employees.  Employers may want to review exemptions with human resources personnel or legal counsel. 

2. The Act provides that covered employers must provide to all employees:

• Two weeks (up to 80 hours) of paid sick leave at the employee’s regular rate of pay if the employee is unable to work because the employee is quarantined (pursuant to Federal, State, or local government order or advice of a health care provider), and/or experiencing COVID-19 symptoms and seeking a medical diagnosis; or
• Two weeks (up to 80 hours) of paid sick leave at two-thirds the employee’s regular rate of pay because the employee is unable to work because of a need to care for an individual subject to quarantine (pursuant to Federal, State, or local government order or advice of a health care provider), or care for a child (under 18 years of age) whose school or child care provider is closed or unavailable for reasons related to COVID-19, and/or the employee is experiencing a substantially similar condition.

3. A covered employer must also provide to employees that have been employed for at least 30 days:

• Up to an additional 10 weeks of paid expanded family and medical leave at two-thirds the employee’s regular rate of pay where an employee is unable to work due to a need for leave to care for a child whose school or child care provider is closed or unavailable for reasons related to COVID-19.

4. What if an Employer Closes -The FAQs state that if an employer closes or furloughs an employee, the employer no longer must provide paid sick leave or expanded family and medical leave. The same is true if you reduce an employee's hours.  
   
   5. What if the Business Offers Paid Leave - An employee must pick one leave or the other.  There are some hybrid choices an employee can make if the employer agrees, including intermittent use of leave. 
   
   6. The FFCRA has Maximum Dollars and Provides Tax Credits: Employers qualify for "dollar-for-dollar reimbursement" through tax credits for all qualifying wages paid under the FFCRA, and can extend to dollars paid for health insurance coverage. The Act sets forth a maximum per diem and aggregate payment caps. The IRS will provide guidance next week on recovering these amounts, but generally has said employers will be able to retain an amount of the payroll taxes equal to the amount of qualifying sick and child care leave that they paid, rather than deposit them with the IRS.   See the DOL Fact Sheet or the IRS page for more information.