The Defense Health Agency (DHA) https://www.health.mil realizes the importance of using telehealth to provide patient care to prevent in-person spread of the coronavirus while still providing quality care to beneficiaries.
As a result, DHA is making three temporary revisions to TRICARE regulations regarding telehealth so DHA published their interim final rule in the Federal Register on May 12, 2020. The rule invokes temporary changes to how beneficiaries and providers can receive and provide telehealth. Changes to regulations requiring publication in the Federal Register usually take six months to a year to implement. DHA wanted to expedite the process due to the need to provide care during the pandemic.
DHA hopes to implement changes to beneficiaries worldwide in 30-90 days. Once implemented, the changes made through the interim final rule will stand as long as the country remains in a state of national emergency.
The first change gives beneficiaries access to audio-only telephone visits with their providers. This change makes it possible for beneficiaries to connect with their providers if they are unable to access audio visual care due to lack of in-home technology, or who live in remote areas without the bandwidth available for video conferencing.
The second change is making it possible for TRICARE to reimburse providers that practice interstate telehealth where permitted by federal or state law, even if the provider in not licensed in the state where care is being provided remotely.
Usually, providers offering telehealth must be licensed in both the state where they practice and the state where their beneficiaries reside. This requirement will be temporarily modified to enable providers to expand their telehealth reach and still qualify for reimbursement. This rule also applies to overseas providers as long as a provider holds an equivalent license in another nation, and with the host nation’s permission.
The third change temporarily waives cost shares and copayments for covered in-network telehealth services. This change doesn’t cover just services related to COVID-19, but covers all telehealth services inside of the network. DHA hopes that by removing these costs, beneficiaries will take advantage of telehealth.
Although the new rules were effective May 12, it will take time for all of the changes to be fully implemented. Beneficiaries may still be assessed a copay for telehealth services over the next few months, but adjudicated claims or copays may be reimbursed. Some changes may remain in effect beyond the national emergency for overseas locations. Once the threat of COVID-19 diminishes, DHA will reevaluate the telehealth changes for the long term.