“I have heart disease, and I am scared. For years, doctor’s visits and medication have kept me alive. However, now I am afraid if I go to the doctor, I will catch coronavirus and die. If I don’t go, my heart disease could kill me.”
I have had similar conversations with seriously ill Americans nationwide who have a host of diseases. They ARE legitimately at greater risk of dying prematurely if they are exposed to the coronavirus – known as COVID-19. Terminally ill patients at the end of their life face an even direr dilemma. They need access to quality medical care to control pain, manage symptoms, reduce suffering and extend their quality of life. A shortage of hospice care could drive them to seek pain and symptom management in already crowded, infectious emergency departments, which would increase their risk of a premature, painful death.
As the nation grapples to contain and treat patients with COVID-19, we’re rethinking how we care for people with other serious or terminal illnesses. Given that patients risk contracting the coronavirus at health care facilities designed to save lives, medicine must adopt accordingly, by replacing brick and mortar medicine with the safe, effective use of telehealth.
Fortunately, late last month the Centers for Medicare and Medicaid Services issued regulations to implement telehealth provisions in the Coronavirus Aid, Relief, and Economic Security Act – known as the CARES Act – that significantly expand patients’ access to telehealth services. They will help ensure that vulnerable populations, including terminally ill patients, can seek care in the safety of their own homes while allowing quarantined doctors the ability to safely deliver quality health care.
- CMS will now pay for more than 80 additional Medicare services when furnished via telehealth. They include emergency department visits, initial nursing facility and discharge visits, and home visits, which must be provided by a clinician that is allowed to provide telehealth.
- Providers can evaluate Medicare beneficiaries, who have audio phones only, a vitally important option for low tech seniors.
- Licensed clinical social worker services, clinical psychologist services, physical therapy services, occupational therapist services, and speech language pathology services can receive payment for Medicare telehealth services.
- Licensed practitioners, such as nurse practitioners and physician assistants, are allowed to order Medicaid home health services during the existence of the public health emergency for the COVID-19 pandemic.