CMS Issues Guidance on Telehealth Coverage and Use to Address COVID-19 Outbreak


On March 24, 2020, the Center for Consumer Information & Insurance Oversight, an agency within the Centers for Medicare & Medicaid Services (CMS), released a guidance document titled “FAQs on Availability and Usage of Telehealth Services through Private Health Insurance Coverage in Response to Coronavirus Disease 2019 (COVID-19).” This FAQ contains information on how states can leverage telehealth technology to address the COVID-19 outbreak, as well as coverage flexibilities available to private health plans pursuant to the public health emergency that was declared by Sec. Azar on January 31, 2020. In this guidance document, CMS announced that it will exercise enforcement discretion that will allow health plans to amend their coverage in the middle of the plan year to expand telehealth benefits and to reduce or eliminate cost-sharing requirements for telehealth services. These flexibilities will endure through the duration of either the public health emergency declared by Sec. Azar or the national emergency declared by President Trump on March 13, 2020.

Accordingly, CMS encouraged health plans to maintain the expansion of telehealth benefits beyond the expiration of the national emergency and public health emergency. CMS also encourages states to similarly exercise enforcement discretion to allow plans to expand their telehealth benefits. To support these efforts, the Office of Civil Rights separately released a policy outlining enforcement discretion regarding requirements of the Health Insurance Portability and Accountability Act to encourage providers to offer telehealth services to patients.

Continue reading to explore the rest of the telehealth flexibilities provided by CMS.


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