Almost 7 million Americans on Medicare use telehealth for doctor visits. But since the government shutdown began last month, access to telehealth has been irregular.
When the government shutdown, Medicare telehealth flexibilities put in place in 2020 expired. Meaning telehealth access reverted to pre-pandemic rules. Before Covid, the Medicare program only covered telehealth services provided at facilities like clinics or hospitals- not in homes. There were also special allowances for mental health and substance use treatment via telehealth.
As the shutdown drags on, health systems are moving forward with little direction on how to deliver care.
“Organizations are responding in different ways and there's a lot of confusion around how to respond,” said Sonya Ebeling, director of the South Carolina Telehealth Alliance.
Ebeling surveyed South Carolina health care systems to find out how the shutdown is impacting patient care. She said some organizations chose to continue providing telehealth to Medicare patients and are holding the claims. Other organizations have stopped scheduling new telehealth appointments and some are requiring all Medicare patients to be seen in-person.
Medicare patients at CareSouth Carolina, a federally qualified health center serving the Pee Dee region are still being seen through telehealth according to Jeri Andrews, the chief medical officer at CareSouth. Although, Andrews said she understands that CareSouth may not be reimbursed for those visits anytime soon.
“Unfortunately the guidance that has been coming out federally has been hit or miss so we have just decided to just stay the course, continue to provide the service and continue to file claims and just go from there,” Andrews said.
Healthcare organizations that have decided to provide telehealth amid the shutdown are hoping that once the shutdown ends, telehealth flexibilities will be reinstated retroactively and claims will be reimbursed.
At a rural health clinic in Bamberg, Medicare patients are still getting the same care through telehealth according to Dr. Danette McAlhaney.
“At Bamberg Family Practice we’ve just decided to go forward with business,” McAlhaney said. “We’re sending the claims out and we will see if they pay, we think they’ll come back and pay at the end…but we aren’t stopping seeing patients, we’re continuing with all the services the same because we want to continue to provide the same care to our patients even during this shutdown.”