When Telehealth went Viral: How the COVID-19 Pandemic Influenced the Rapid Move to Virtual Medical Treatment, and What Non-Rural Providers Not Treating COVID-19 Patients Should Do About It

Abstract

“COVID-19 has changed the way we view medicine and we’re not going to go back,” Martin Schreiber, MD, chief medical officer for DaVita Kidney Care’s home treatments, said during his virtual presentation at the Annual Dialysis Conference.  “We just have to get better at providing telemedicine.  Everyone that is part of the health care team needs to get better at it.”   The rapid spread of the virus has forced health systems to pivot and adapt to its effects.  Experts estimate that we have made 10 years of progress in the required migration to telemedicine over the first three months of the Coronavirus Disease of 2019 (COVID-19) pandemic, which was caused by an outbreak of the strain of novel beta coronavirus that began to spread in 2019 .  In order to understand the impact of the pandemic on independent, non-rural physician practices not treating COVID-19 patients, we need to understand how each component of the response to the pandemic has directly affected these practices, including:  Stay-at-home orders and the abrupt decline in patient visits due to voluntary compliance with movement restrictions and the forced cancellation of elective medical procedures.  Also important is the distinct lack of federal funds directed to these practices – especially those who do not bill Medicare.  It is essential to consider the regulatory response, which includes the prosecution of providers who do not adhere to licensing restrictions when practicing via telemedicine, and the temporary suspension of the enforcement of the Privacy and Security rules.  Similarly, it is vital that practices pay attention to the increased federal funding of enforcement activities designed to pick up irregularities in billing practices regarding the provision of telemedicine services when implementing or increasing their telehealth offerings.  Virtual medical care has been a life raft for these independent practices as they try to rebuild their business, but it is essential that they pay attention to the risks presented by the regulatory landscape in order to avoid an enforcement coup de grace.