A New Era in Telemedicine Fueled by COVID-19 Regulation Changes

Regulation changes from the COVID-19 pandemic have fueled a new era in telemedicine

March 16, 2020 – As part of the recent declaration of a COVID-19 state of emergency, the Commonwealth of Massachusetts is mandating that all payers cover medically necessary telemedicine and telehealth testing and treatment for the novel strain of coronavirus.

Government Charlie Baker announced a slew of emergency actions to address COVID-19 in the Commonwealth of Massachusetts on Sunday night.

“Our administration is taking these rapid steps to protect the health and safety of our residents to mitigate the spread of COVID-19,” said Baker. “With the steps we are taking today, we can ensure residents can still access key state services while taking necessary precautions to limit the spread of COVID-19.”

Included in the actions is an order to expand access to telehealth services and protect healthcare providers.

The most important provision states that all commercial insurers, self-insured plans, and the Group Insurance Commission to cover medically necessary telehealth services. (GIC administers health insurance and benefits for state employees and retirees.) The order specifies that all payers in the state “are required to allow all in-network providers to deliver clinically appropriate, medically necessary covered services to members via telehealth.”

The order prevents payers from imposing restrictions on the technology used to deliver telehealth services and reimbursing services delivered via telehealth at a lower rate. As for billing, payers are responsible for notifying providers about billing requirements.

Furthermore, payers cannot impose cost-sharing via copayments, deductibles, or coinsurance for COVID-19 treatment delivered using telehealth. Likewise, the order stipulates that prior authorization is not required to receive medically necessary treatment of coronavirus by in-network providers using telehealth.

The order goes into effect March 16, 2020, and will continue until the Commonwealth lifts its state of emergency or rescinds the order.

Other healthcare-related provisions of the governor’s COVID-19 declaration include:

  • All assisted living residences are to ban visitors to protect the health of residents and staff. This is in addition to the federal guidance issued on Friday that bans visitors to nursing homes and rest homes.
  • All hospitals operated by the Department of Public Health or the Department of Mental Health are to screen all visitors and restrict visitation if individuals show any indication of illness.
  • Hospitals must cancel non-essential elective procedures.
  • Authorizes licensed pharmacies to create and sell hand sanitizer over the counter.

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