CMS Relaxes Some HIPAA Concerns in the Time of COVID-19

As the use of telehealth expands to accommodate both patients and providers through the COVID-19 public health emergency, CMS loosened some of the HIPAA requirements that might otherwise hinder this process.  On March 17, 2020, the U.S. Department of Health and Human Services (HHS) issued a series of “1135 waivers” (link here), some of which address concerns pertaining to the security of some communications technologies used in telehealth services.

As long as providers are working with the good faith provision of telehealth, the Office of Civil Rights will “exercise its enforcement discretion and will not impose penalties” if the communication technologies do not fully comply with the HIPAA Rules requirements.   This allows the use of communication through a variety of video applications such as Skype, Facetime, ZOOM or EyeCareLive.  The notice states that Facebook Live, TikTok and similar public-facing video communication applications should not be used in providing telehealth by covered health care providers.

Expanding Access

Starting March 6, 2020, Medicare can pay for office, hospital, and other visits furnished via telehealth across the country from a variety of settings, including patients’ places of residence.  Telehealth may be offered by a variety of providers including doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers.  Prior to this waiver, telehealth was only reimbursed when the person receiving the service is in a designated rural area.  Even then, patients had to leave their homes and go to a clinic, hospital, or certain other types of medical facilities for the service.

Additionally, the HHS Office of Inspector General (OIG) is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs.


Providers should take care to document these encounters appropriately.  Note that this was a virtual, not face-to-face, encounter.   Obtain and document the patient’s verbal consent to proceed.  If the provider does not have access to EMR at the time of the encounter, any handwritten notes made during the virtual visit should be scanned in to the system or retained in a paper chart.  The notification is available on the HHS website (link here), in  the Office for Civil Rights, HHS BULLETIN:  HIPAA Privacy and Novel Coronavirus (link here) and in CMS’ Medicare Learning Network MLN Matters SE20011 (link here).

We are happy to assist you with claims issues and other topics related to eye care during this public health emergency.  Check back often for updated News Items related to billing, documentation, and operations related to your practices during COVID-19. (800) 399-6565

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