Illinois Gov. J.B. Pritzker has issued an executive order relaxing rules on telehealth for Medicaid and private insurers in an effort to help those affected by the novel coronavirus pandemic.
With the new measures listed under Executive Order to Expand Telehealth Services and Protect Health Care Providers in Response to COVID-19, telehealth services would be fully reimbursed by insurers just as if the patient had visited a doctor’s office. The expansion of telehealth services will not be limited to the coronavirus pandemic only, but will include other health care services such as for mental health and substance abuse treatment.
Increasing access to telehealth
This order will remain in place for the duration of the coronavirus outbreak.
Farmweek Now reported that for plans regulated by the Department of Insurance, the executive order calls for providers to be reimbursed at the same rate at which they are reimbursed for in-person visits and prohibits private health insurers from imposing any cost-sharing for in-network providers. An exception includes those enrolled in high-deductible health plans who have not yet met their deductible amount and for which the health service is not preventative care.
With this order, Pritzker’s administration wants to increase access to telehealth and the number of health care providers that can screen patients, allow 90-day prescription supplies without prior authorization and early refills, as well as several other items that will increase flexibility and provide additional resources, it was reported.
Telehealth expansion is particularly meant to benefit seniors, who are the most vulnerable to the coronavirus and also have to visit doctors’ offices for regular checkups.
Jordan Powell, president of the Illinois Primary Health Care Association, praised the move towards flexibility, but said telehealth regulations need to be lessened further “because we need to be especially flexible in the healthcare delivery system right now. The more we can care for our patients out of the health center setting gives us the internal capacity to take care of those that truly need to be treated and seen immediately.”
Powell furthermore said that: “We’re really pleased to see that (the Department of Healthcare and Family Services) is taking action to provide greater flexibility through telehealth, and we think it is a great first step.”
Major disaster declaration
After Pritzker’s executive order, the federal government approved Illinois’ request for a federal major disaster declaration, which will provide emergency funding to increase hospital and housing capacity, as well as resources to expand telehealth.
“This declaration will provide emergency funding to increase hospital and housing capacity as we respond to this unprecedented health crisis. This declaration also provides resources to expand telehealth, allowing us to safely reach more Illinoisans in need of care,” Pritzker explained.
Pritzker’s executive order is in keeping with developments at a federal level. Recently, the federal government announced it was expanding Medicare telehealth coverage during the coronavirus crisis so that beneficiaries can receive a wider range of healthcare services from their doctors without having to travel to a healthcare facility.
Since March 6, Medicare — administered by the Centers for Medicare & Medicaid Services (CMS) — has been temporarily paying clinicians to provide telehealth services for beneficiaries across the entire country. An official said the changes were meant to allow seniors to communicate with their doctors without having to travel to a healthcare facility thereby limiting their risk of exposure and the spread of the coronavirus.
On March 13, President Trump announced an emergency declaration under the Stafford Act and the National Emergencies Act. Following the emergency declaration, CMS is expanding Medicare’s telehealth benefits under the 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act
As of March 27, Illinois had confirmed 2,538 cases of the novel coronavirus while 26 people had died due to the virus.
On March 26, Chicago reported 673 new coronavirus cases, the biggest one day rise since daily announcements began.
A vaccine for the coronavirus is yet to be found. Moderna Inc, Inovio Pharmaceuticals Inc, and Novavax Inc are some of the companies that have announced they are working to develop vaccinations against the virus. The World Health Organization has also announced that Gilead Sciences’ drug, remdesivir could help treat the deadly coronavirus.
You can read our comprehensive guide on telemedicine here.