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New COVID-19 Telehealth Guidance More Explicitly References Home Care 

The state Department of Health (DOH) has updated its previous Medicaid Update on COVID-19 telehealth/telephonic billing and services allowances to more explicitly include home care and each discipline within home care following multiple appeals from HCA.

The new Medicaid Update, dated March 23, is here and may undergo future updates that providers should watch for.

Please specifically refer to the “Telephonic Reimbursement Overview”  table, which is intended to show payment pathways for telehealth using the “usual billing structure.” The revised version of the chart now specifically mentions home care services and rate codes under Billing Lanes 5 and 6 for “assessment and patient management” and “other services.”

HCA has communicated continuously with the Department over the last several days for more explicit practice, service and billing code recognition of home care in this guidance. We appreciate DOH’s responsiveness to our request. Members with questions or further needs on telehealth are encouraged to contact the HCA Policy staff.

Other updates

Yesterday, Governor Cuomo issued another in a near-daily set of Executive Orders. Executive Order No. 202.10 “permit(s) registered nurses to order the collection of throat or nasopharyngeal swab specimens from individuals suspected of being infected by COVID-19, for purposes of testing.”In addition, the Executive Order allows a hospice residence to designate any number of beds within such facility as dually certified inpatient beds.

Another section of the order provides relief from record-keeping requirements. It mentions “relief to the extent necessary for health care providers to perform tasks as may be necessary to respond to the COVID-19 outbreak, including, but not limited to, requirements to maintain medical records that accurately reflect the evaluation and treatment of patients, or requirements to assign diagnostic codes or to create or maintain other records for billing purposes,” granting “absolute immunity from liability for any failure to comply with any recordkeeping requirement” if done so in good faith except in certain circumstances.

UPDATE: HCA has confirmed the applicability of this provision with state Department of Health officials who state that the reference does cover home care providers; however, the licensed home care professional is only protected from liability if they are not maintaining accurate patient records due to their COVID-19 response (e.g., having a patient surge due to a COVID-19 outbreak). Licensed home care professionals could not use this waiver provision generally to avoid keeping accurate patient medical records, regardless of the COVID-19 connection.

Please continue to watch our COVID-19 resources page for the latest summary of waivers or suspended regulations.