In this second of a two-part video interview with MHE, Amwell Chief Medical Officer Peter Antall says he is in favor of extending CMS waivers that made telehealth visits reimbursable and easy for patients and providers.
During the many months COVID-19 has affected millions, there have been many regulations and waivers of certain restrictions on reimbursement. Amwell Chief Medical Officer, Peter Antall, is in favor of extending CMS waivers that made telehealth visits reimbursable and easy for patients and providers.
"Our goal now is to make permanent, those waivers that make sense," Antall says. Medicare rules that drew tight restrictions around telehealth visits are a “remnant of different time.”
Not all of the waivers will remain permanent, for example, the waiver of enforcement of HIPAA, he says. However, many of the waivers, like the waving of CMS, is citing geographic restrictions for reimbursement.
"We've been working on that change for a long time now," he says about the waivers. "An elderly patient should not have to be in a rural area and not have to present themselves to a clinical site to obtain telehealth and have it reimbursed. This is a remnant of a different time. High quality, robust care can be delivered to a patient wherever they are on consumer grade devices like Zoom, FaceTime or other non-medical grade ways of interacting by video."
Still, Antall says the loosening of HIPAA rules that allowed telehealth visits to be conducted over Facetime, Zoom and other “non-medical grade” connectivity software needs to be reversed.
“HIPAA is there to protect patients and their personal health information. I think we are all aligned with that," he says. "We don’t want our personal health information sitting on servers at Apple, for example, which it may very well be right now if you used Facetime for a medical visit.”
Antall believes the idea is you can have an "ease of use" in use of telehealth and HIPAA compliance. This idea would favor Amwell and its investment in HIPAA-compliant, “medical grade” telehealth connectivity.
He adds other companies have jumped into the very active and growing telehealth market.
“All of sudden, our traditional competition might have been Teladoc and others in the past. Now our competition might be Microsoft Teams and Zoom and all those other folks," he says. "They are well within their rights and they have plenty of coders to make sure their products are HIPAA compliant.”
Antall also mentions the priorities of customers have changed.
“It was a year ago, prior to COVID, the priorities for most providers was interoperability. When COVID hit and the need to engage, all of sudden ease of use became higher up in the priority order,” he says.
In addition, Amwell has rolled out a product, Amwell Now, that is HIPAA-compliant and easy to use. “It is built to be simpler and easy to use, not full of bells and whistles, not all about interoperability,” Antall says.
Amwell is focused on synchronous video because they believe it is the most robust way to interact with a patient electronically. Antall also sees a role for audio-only if there are insurmountable problems with the video connection. However, he says it has to be “enhanced telephony,” not just a plain-vanilla phone call, and that enhanced telephony means having patient records available, intake forms, codes for billing and creating an auditable record of the visit.
Amwell is concerned about maintaining the quality of care but also preventing fraud, waste and abuse. “We are not here to be a pill mill. We are not here to encourage or facilitate anyone to practice bad medicine or fraudulent,” he adds. "We're here to support good high quality care."