4 Telehealth Concerns For Care Management After COVID-19

June 17, 2020 by Christen Aldrich

Filed under COVID-19 for Employers, COVID-19 for the Workforce, Telehealth

Last modified June 18, 2020

In a recent article by Law360, concerns for care management post-pandemic are examined. The COVID-19 pandemic has created an urgent need for alternative approaches to patient health assessments, patient monitoring, and patient education to reduce additional exposure to the virus and ease the financial and psychological toll on health care providers and facilities. While some providers and payers utilized remote care management and patient monitoring modalities prior to the pandemic, the pandemic has accelerated the adoption of these remote techniques and telehealth platforms.

We expect the trend toward use of telehealth platforms to persist after the pandemic. As providers reel from unexpected heavy losses incurred during the pandemic, care management organizations increasingly shifting to telehealth platforms can position themselves as valuable revenue sources and partners in the delivery of much needed care. Before taking the plunge into telehealth, care management organizations should take care to:

1. Select a technology vendor with a strong HIPAA compliance background and, if applicable, negotiate nonstandard provisions in a subcontractor business associate agreement to ensure obligations comport with business associate agreements executed with covered entities.

2. Negotiate for a software license that will give the best flexibility to expand the care management team and share the platform with providers in response to patient needs. As necessary, mitigate against potential anti-kickback law enforcement risks.

3. Where required by state law, form professional entities that are capable of employing or arranging for the professional activities of professionally licensed care management team members to reduce enforcement risk in states that generally prohibit the corporate practice of professional services.

4. Closely examine coding and billing practices against payer policies to mitigate revenue cycle compliance risks.

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