decisionhealth Newsletters, Part B News - 2023 Issue 10 (October)
Check your Medicare telehealth compliance against HIPAA, DEA rules
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Article Overview
This article reviews Medicare telehealth compliance in the context of continuing pandemic-era flexibilities, privacy requirements, and controlled-substance prescribing limits. It is aimed at clinicians, coders, and practice staff who manage telehealth services for Medicare patients and need a high-level understanding of the regulatory areas that still apply. The discussion covers Medicare telehealth waiver timing, HIPAA-related platform considerations, and DEA-related restrictions affecting certain telehealth encounters.
Why This Topic Matters
Telehealth billing and service delivery can be affected by multiple overlapping federal rules, so practices need to know which flexibilities remain in place and which outside requirements still apply. Understanding the scope of the article helps readers assess compliance risk for Medicare telehealth workflows without relying on assumptions about waiver status.
Article Sections
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Compliance
Overview of Medicare telehealth flexibilities and the need to consider other federal requirements that also affect telehealth delivery.
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HIPAA restricts typical telehealth services
Discussion of privacy-related requirements for real-time telehealth services and the effect of OCR-related platform considerations on service delivery.
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The DEA restricts telephone services
General coverage of DEA-related telehealth limits, including the interaction between audio-only encounters and controlled-substance prescribing during telehealth visits.
What You Will Learn
- How Medicare telehealth flexibilities relate to broader federal compliance requirements
- What general HIPAA-related considerations affect telehealth platform use
- How DEA-related telehealth limits can affect encounters involving controlled-substance prescribing
- Why temporary waiver timing matters for Medicare telehealth workflows
Who Should Read This
- Physicians and other clinicians
- Medical coders
- Billing and reimbursement staff
- Practice managers
- Compliance staff
Codes Discussed
Code Ranges Discussed
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