On January 7, Alex M. Azar II, Secretary of Health and Human Services, renewed the state of affairs related to the COVID pandemic as a Public Health Emergency for another 3 months. Since January 2020, The Public Health Emergency Declaration is effective for 90 days after each renewal. This latest renewal occurred on Jan. 7, 2021, becomes but effective on Jan. 21, and will last until Apr. 21, 2021. Significant federal and state telehealth policy expansions are tied to the PHE declaration, including flexibilities for reimbursement in the Medicare program, as well as some telehealth expansions in Medicaid. More specifically, the federal PHE has led to numerous waivers that are interpreted differently by different states. Being a federal program, Medicare waivers for telehealth reimbursement will continue through April 21, as will enforcement discretion related to HIPAA.
With this extension of the PHE to April then, providers get additional time to use waivers for telehealth and other pandemic-related flexibilities that are regulatory in nature. In addition to these flexibilities, the public health emergency holds accountable care organizations harmless from financial losses for the duration of the PHE. For example, if the PHE is in effect through July 2021, then ACOs will only be liable for less than half of the shared losses experienced this year. The many waivers and other regulatory changes set into motion by the PHE, outlined here: COVID-19 Public Health Emergency Extended: HHS Declared.
Previous Renewal Dates
The first declaration of a PHE was made by Secretary Azar on January 31, 2020, following the determination, following the World Health Organization’s decision to declare the coronavirus a public health emergency of international concern. Subsequent renewals occurred on April 21, 2020, October 23, 2020, my January 31, 2020. Each renewal is effective for 90 days. Such renewals then keep in effect the previously established governmental waivers and other regulatory changes that allow for a freer flow of telehealth throughout the country. Reimbursement issues are particularly impacted by these Public Health Emergency renewals for details see:
- Telehealth Reimbursement News October 2020
- Expanded Telehealth Coverage for Medicare, Medicaid & Chip
- Route to Expanding State Telehealth Medicaid Programs Post-COVID-19
- Telehealth: Omnibus Appropriations and Coronavirus Relief Spending Bills
The American Hospital Association asked President-elect Joe Biden to extend the public health emergency. The AHA requested that providers be allowed to retain provider relief fund dollars by allowing for any reasonable method of calculating COVID-19-related lost revenue, movement of targeted distributions within a system, and use of funds for increased staffing costs. Given the recently announced Telehealth Support through Omnibus Appropriations & Coronavirus Relief Spending Bills in December of 2020, funding relief is now available to many behavioral health groups.
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- Mental Health Telemedicine Expansion Act and Telehealth
- Permanent Expansion of Medicare Telehealth Reimbursement Announced by CMS
For a complete summary of temporary COVID-19 federal telehealth policies and when they expire, see CCHP’s Federal COVID-19 Emergency Action Chart. To see a complete list of all of the state COVID-19 emergency actions, see CCHP’s COVID-19 State Action webpage.