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Home Coronavirus Preparedness and Response Supplemental Appropriation Act of 2020 expands telehealth landscape

Coronavirus Preparedness and Response Supplemental Appropriation Act of 2020 expands telehealth landscape

The passage of the Affordable Care Act in 2010 significantly expanded Americans’ access to telemedicine. By transitioning the country’s healthcare system from a fee-for-service model to one that focuses on positive patient outcomes, medical executives quickly took steps to streamline patient communications and appointments. 

A recent survey by American Well confirms this trend. Currently, about one in five American physicians offers telemedicine services. That’s a significant increase from 2015 when only 5 percent of physicians did. In addition, by 2022, 61 percent of physicians who don’t already offer telemedicine services plan to do so. 

Unfortunately, challenges for telemedicine still remain, even with increased adoption. However, with the passage of the Coronavirus Preparedness and Response Supplemental Appropriations Act on March 6, 2020, the government is addressing some of these challenges much quicker than originally expected.


What is the Coronavirus Preparedness and Response Supplemental Appropriations Act?

The Coronavirus Preparedness and Response Supplemental Appropriations Act is legislation that sets aside $8.3 billion in emergency supplemental appropriations to combat the spread of the novel coronavirus, and the disease it causes, COVID-19. 

The act sets aside funding for a series of actions, including:


  • The research and development of vaccines and other therapeutic treatments
  • Increased prevention, preparedness, and response efforts for state and local agencies
  • The purchase of necessary medical supplies like ventilators and N-95 masks
  • The support of American allies around the world fighting the virus


Under 1135 waiver authority, the Coronavirus Preparedness and Response Supplemental Appropriations Act also expands the use of telehealth services to Medicare recipients. 

This change allows Medicare beneficiaries––many of whom are elderly or suffering from chronic medical conditions like heart disease and diabetes––to access a wider range of services from their primary care providers without having to visit a medical facility. 

The expansion of telehealth services under the 1135 waiver isn’t permanent but will last until the coronavirus public health emergency ends. 


How does the 1335 waiver change access to telehealth services?


Before President Trump used the waiver authority provided by 1135, Medicare beneficiaries only had very limited access to telehealth services. 

For example, Medicare only covered telehealth services for people living in rural areas, and all telehealth appointments required patients to visit a designated medical facility, like a clinic or hospital. 

Thanks to the waiver authority provided by 1135, Medicare patients in any area of the country can now receive telehealth services. They can also participate in appointments from the comfort of their own homes, without having to visit a designated facility. 1135 also does away with The Centers for Medicaid and Medicare Services’ (CMS) “established relationship” requirement.

Many Medicare beneficiaries are older and living with underlying health conditions. As a result, they’re also more susceptible to the life-threatening complications caused by COVID-19. 

The waiver also allows a variety of medical providers (not just general practitioners) the ability to offer telehealth services to Medicare clients, including certified nurse anesthetists, clinical psychologists, registered dieticians, and nutritional professionals. 

This means patients can receive care outside the scope of coronavirus-related complications. In short, Medicare patients now have the option to access any type of necessary health service, including counseling and healthy living advice without visiting multiple facilities or specialists. 

Third, under CMS’ original established relationship requirement, Medicare patients could only participate in telehealth services after meeting with their physician in person. The Department of Health and Human Services (HHS) has waived this requirement to limit travel as much as possible. In addition, physicians and other specialists will no longer risk a government audit by providing telehealth services to Medicare recipients.


Waiver 1135 and telehealth technology

Waiver 1135 also features wording that addresses the use of specific technologies. 

Under CMS’ old telehealth guidelines, physicians and medical specialists conducting telehealth services had to use telecommunications technology with audio and video capabilities used for “two-way interactive communications.” This wording excluded the use of smartphones, adding another obstacle for Medicare patients.

Under 1135, physicians and medical specialists can furnish Medicare telehealth services using telephones that have audio and video capabilities (smartphones). The HHS Office for Civil Rights also announced that it will waive penalties for HIPAA violations against providers that serve patients through modern services like FaceTime and Skype.

While these changes are only temporary, Waiver 1135 expands telehealth services to Medicare recipients in a big way. This protects vulnerable patient populations, prevents long lines in medical waiting rooms across the country, and allows physicians and other medical specialists the freedom to address minor, non-life-threatening issues over the phone and internet. 

It’ll be interesting to see if these changes become permanent following the end of the pandemic. Here at DocCafe, we’re watching this story closely and will provide updates as they become available. You can also learn more about Waver 1135

Coronavirus Preparedness and Response Supplemental Appropriation Act of 2020 expands telehealth landscape
Chad Birt

Chad Birt is a freelance B2B and B2C medical writer who resides in Astoria, Oregon. When he isn't behind a keyboard, you can find him hiking, camping, or birdwatching with his wife Ella and their two dogs, Diane and Thoreau.