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  • Coronavirus Update: March 23, 2020

    Tips on what to ask about telehealth; guidance on paid leave law; coronavirus "self-checker"; CMS enrollment relief, and more.

    Practice Guidance

    March 23: APTA Recommends PTs Ask Specific Questions About Telehealth Provisions
    As telehealth provisions evolve rapidly at the state, federal, and private payer levels, it's crucial that PTs fully understand what does and doesn't apply to them. Here are five questions to ask payers and state agencies.

    March 19: APTA Private Practice Section Provides Guidance on Paid Leave Law
    The Families First Coronavirus Response Act signed into law last week includes requirements for employers with fewer than 500 employees to provide paid sick time and extended FMLA leave. This resource from the APTA Private Practice Section provides a summary of the law, and suggestions on next steps for private practices.

    March 19: APTA Private Practice Section Publishes "General Considerations" Related to COVID-19
    There are growing list of "what ifs" that PTs in private practice need to consider around the coronavirus — this resource from the APTA Private Practice Section covers a range of possible scenarios, ranging from employee illness to responding to drops in demand.

    From the CDC

    March 23: CDC Debuts Online Coronavirus "Self-Checker"
    The CDC is now offering an app designed to help individuals who wonder if they're experiencing COVID-19 symptoms. Called "Clara," the program asks a series of questions that include symptoms being experienced, age, geographic location. Based on answers provided, Clara recommends actions to be taken, from calling 911 to staying home and contacting a health care provider.

    From CMS

    March 23: CMS Issues FAQs on Medicare Provider Enrollment Relief
    As part of the 1135 waiver process in place during the coronavirus pandemic, CMS is easing some requirements related to provider enrollment in Medicare, including waivers to site visits and criminal background checks associated with fingerprint-based background checks, as well as postponement of all revalidation actions. This recently published list of frequently asked questions about the waivers includes a list of Medicare Private Enrollment Hotline numbers.

    From the Department of Labor

    March 22: Labor Department Provides Information on Paid Leave Law, Fair Labor Standards Act
    With the Families First Coronavirus Response Act now signed into law, the U.S. Department of Labor has published resources that explain the essential elements of the mandated paid leave now in place for employers of fewer than 500 people. Also included on the page: questions and answers about the Fair Labor Standards Act and the Family and Medical Leave Act.

    In the Media

    March 23: IBM and DOE Launch COVID-19 Computing Consortium
    IBM has partnered with the Department of Energy to launch the COVID-19 High Performance Computing Consortium, which will combine supercomputing capabilities from 16 systems to help researchers better understand SARS-CoV-2 and develop potential therapies and a vaccine. Consortium partners include Lawrence Livermore National Laboratory, Oak Ridge National Laboratory, Los Alamos National Laboratory, the National Science Foundation, NASA, Massachusetts Institute of Technology, Amazon, and Google.

    March 22: FTC Warns of Coronavirus Scams
    The Federal Trade Commission is warning the public of malicious websites, robocalls, and other scams -- including dishonest websites selling disinfectants and medical supplies, and others selling unapproved products purporting to cure or prevent contracting the virus.

    March 22: Therapy Continues During Crisis, But Worries Over Protective Supplies and Employment Loom
    From Skilled Nursing News: "Even with heightened concern amid the spread of the virus, and with the threat of protective gear declining, therapists are still jumping in to help patients get well — in spite of great risk and putting in extra hours."

    March 19: Nursing Home Outbreaks Lay Bare Chronic Industry Problems
    From Associated Press: " Burgeoning coronavirus outbreaks at nursing homes in Washington, Illinois, New Jersey and elsewhere are laying bare the industry’s long-running problems, including a struggle to control infections and a staffing crisis that relies on poorly paid aides who can’t afford to stay home sick.”

    Visit APTA's Coronavirus webpage for more information and updates.

    Asking the Right Questions About Telehealth

    It's not enough to ask if telehealth is permitted by a state agency or payer: You need to ask specific questions to understand what you can and can't do.

    As the coronavirus pandemic worsens, PTs and PTAs are looking for answers around what they can and can't do in terms of telehealth. APTA's advice: Get the right answers by asking the right questions.

    According to Alice Bell, PT, DPT, APTA senior payment specialist, in addition to federal-level changes around digital communications with patients, the telehealth environment is also evolving rapidly at both the private payer and state regulatory levels.

    "Right now, there's a great deal of confusion around the coverage of telehealth when provided by physical therapists," Bell said. "Some broad policies and federal and state legislation may be interpreted as including physical therapists even though this is not explicitly stated."

    Daniel Markels, APTA state affairs manager, says that miscommunication can make matters worse.

    "If a PT calls a payer and asks if telehealth is covered, the payer may say yes not knowing that it's a PT asking the question or what codes the physical therapist intends to bill," Markels said.

    That's why APTA recommends that, besides having a solid understanding of the limitations in state licensure scopes and relevant state and federal laws, PTs ask the following questions when communicating with a payer or state agency about whether telehealth is permitted for physical therapist services:

    • Will services provided by physical therapists (and PTAs working under the direction and supervision of the PT) be covered when provided via telehealth?
    • If so, what codes should be billed and what modifiers are required?
    • What device(s) or application(s) can be utilized?
    • What, if any, consents are required?
    • Are there any special documentation requirements?

    [Editor's note: Official guidance and best practices related to telehealth and e-visits could change rapidly as the COVID-19 outbreak continues to evolve. For the most current information from APTA, see our main Telehealth webpage and visit our APTA.org/Coronavirus/ webpage.]