Insurers to Cover Visits Governor Abbott waived certain regulations and directed the Texas Department of Insurance (TDI) to issue an emergency rule relating to telemedicine provided through state-regulated insurance plans. Contracted or preferred physicians and other health care professionals will be eligible for payment from TDI-regulated insurance plans for medical visits they conduct over the phone instead of in person at the same rate they would receive for in-person visits.
HIPAA Restrictions Suspended Effective immediately, the U.S. Health and Human Services (HHS) Office for Civil Rights will not penalize physicians for noncompliance with HIPAA when they serve patients in good faith through common, nonpublic-facing communications technologies, such as FaceTime or Skype.
Medicare Telehealth Expands The Centers for Medicare & Medicaid Services (CMS) has temporarily broadened telehealth access to Medicare patients. Medicare can pay for office visits furnished via telehealth in all areas of the country (not only rural areas) and in any setting, including in a patient’s home. Physicians may reduce or waive cost-sharing for telehealth visits paid by federal health care programs.
Learn More About These Changes
As COVID-19 spreads through our communities, there are steps you can take to minimize contactwith patients. A primary step is to implement telemedicine. TMA has developed some quick tips to help you get started.
The following list reveals the key functionality of the various telemedicine products as reported by the vendors on their own websites. TMA has not vetted these companies but wanted to provide information for physicians seeking to implement telemedicine into their practice. This list is not exhaustive and is separated by companies offering stand-alone products and those that have electronic health record (EHR) integrations.
Be sure to execute a business associate agreement with the telemedicine vendor.
View the Vendor Details
Telemedicine has the opportunity to transform a physician’s practice. As the service becomes more readily available through health plans and employers, patients are expecting more from their own physician. It makes sense for a patient to have the choice to see their own doctor for continuity of care and comfort in times of illness and uncertainly.
TMA created this evaluation tool to help Texas physicians with some of the criteria to consider in the selection of telemedicine vendor products.
See the Telemedicine Vendor Evaluation Criteria
Texas telemedicine laws and regulations have changed considerably over the past several years, and access has been greatly expanded because of the COVID-19 pandemic.
For example the Texas Medical Board has declared that telemedicine – including the use of telephone only – may be used to establish a physician-patient relationship, under a statewide disaster declaration issued last week.
In the wake of COVID-19, TMA is getting calls about which payers are covering telemedicine. TMA developed this quick reference guide to help you navigate telemedicine reimbursement. This table now reflects Medicare’s waiver of the geographic and place of service restrictions for Medicare (which means patients can now be at home).
Additionally, the Governor directed TDI to issue an emergency rule related to the payment of telemedicine to allow state-regulated plans (about 20% of the commercial market in Texas) to allow telephone and telemedicine visits to be paid at the same rate as in-office visits. If you are not sure which patients are regulated by TDI, check this guide. Stay tuned for more detail.
The use of telemedicine has been expanded so physicians can safely and effectively treat patients during the COVID-19 pandemic.
However, some people don’t have smartphones with video capability, meaning visits will have to be done via old-fashioned phone calls.
Which health plans cover telephone-only patient visits, and what exactly do they pay for?
The U.S. Drug Enforcement Administration (DEA) will allow physicians to issue prescriptions for all schedule II-V controlled substances via telemedicine as long as specific conditions are met.
Administration and Billing
In response to Gov. Greg Abbott’s COVID-19 “state of disaster” declaration Friday, the Texas Medical Board (TMB) has taken several steps to help Texas physicians safely and effectively care for patients.Those actions include expanding the use of telemedicine, temporarily waiving license and permit renewal requirements, and allowing retired physicians to return to active status.
The Texas Medical Association and organizations like the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization are encouraging physicians to consider how they will respond to big surges in sick patients needing care; critical staff becoming ill or unable to come to work; and protecting non-infected patients from exposure to the virus from other patients in the office.
Could telemedicine be part of the solution for your practice?
The Texas Medical Association (TMA) joined The Physicians Foundation, American Medical Association, Florida Medical Association, and Massachusetts Medical Society in launching The Telehealth Initiative to help physicians start telehealth care. With the current health crisis, the organizations sped the initiative’s launch to help physicians shift to telehealth to meet patients’ needs from their homes where they cannot transmit COVID-19 or other diseases to other people.
How well do you understand Texas’ laws and regulations relating to telemedicine? This document describes the new Texas legal and regulatory requirements that apply to a physician providing telemedicine medical services.
This white paper was updated in August 2019.
Don't miss out on free CME for TMA members. This publication qualifies for 1.5 AMA PRA Category 1 Credits™.
Read the White Paper
Telemedicine can provide patients with considerable convenience and satisfaction, but challenges still exist with insurance payments and bottom-line value for individual physicians. That’s what physicians who have successfully integrated telemedicine into their practices told fellow doctors during Saturday’s Dawn Duster presentation at the 2019 Texas Medical Association Fall Conference.
A growing number of physicians are embracing telemedicine.
Because most physicians still have no first-hand experience with it, they have many questions about how it will help them and their patients.
Telemedicine is rapidly evolving, and the number of physicians who use it continues to grow.
Whether you use telemedicine every day in your practice or you’re just starting to consider how it might benefit your patients, you probably have plenty of questions and concerns about using it effectively and within compliance.
That’s why the Texas Medical Association formed a task force that will help TMA serve physicians who want to integrate telemedicine into their practice.
It’s time for Texas to hit the accelerator on fostering more telemedicine use in Medicaid, the Texas Medical Association and several other organizations are telling the Texas Health and Human Services Commission (HHSC).
Texas’ new telemedicine law and applicable rules have created new opportunities for physicians to care for patients outside the traditional office visit. Here are answers to three basic questions you might have. (Remember: When treating Medicare patients via telemedicine, follow Medicare rules.)
Texas Medical Board FAQs Regarding Telemedicine During COVID-19 Crisis
Telehealth Remote Communications During COVID-19 - HHS.gov
Medicare Telehealth FAQs re: COVID-19 - CMS
Medicare Telemedicine Health Care Provider Fact Sheet - CMS
Go to the TMA COVID-19 Resource Center
Quick Tips: Getting Started in Telemedicine (podcast) – Incorporate telemedicine amid COVID-19.
Telemedicine: The Changing Shape of Care (webinar) – Explore the practice benefits of telemedicine.
TMA members are eligible for a free technology contract review from Coker Group – including a contract review of telemedicine vendor services. Evaluations focus on potentially unfavorable terms with feedback on identified concerns.
Submit Your Contract
View this webinar for a general look at telemedicine and virtual visits and how they may benefit your patients. It's free for TMA members!
View the TMA Webinar
Have questions about telemedicine? Call or email the Knowledge Center.