Telemedicine Guidance & Resources

In response to the growing novel coronavirus (COVID-19) pandemic, the Trump Administration announced that the federal government is immediately suspending HIPAA enforcement and penalties to facilitate use of telehealth for health care services in both the Medicare and Medicaid programs. The California Medical Association (CMA) is continuing to urge Governor Gavin Newsom to follow suit and issue an executive order that would facilitate greater adoption of telehealth services. We hope the Governor issues an order today, but California data and security laws remain in effect presently. ACCMA will send out a member alert when this changes.
 
For additional information, the ACCMA has recorded a podcast addressing issues and concerns about telehealth, HIPAA, and COVID-19. Listen in on a Q&A with Joseph Greaves, Executive Director at the Alameda-Contra Costa Medical Association and David Ginsberg, HIPAA advisor for the ACCMA and the California Medical Association, providing great insight to support providers to implement telemedicine in their practice in this emergency situation while maintaining HIPAA compliance.
 

Recommended strategies include:

  • Using your telephone system to deliver messages to incoming callers about when to seek medical care at your facility, when to seek emergency care, and where to go for information about caring for a person with COVID at home.
  • Adjusting your hours of operation to include telephone triage and follow-up of patients during a community outbreak.
  • Leveraging telemedicine technologies and self-assessment tools.

The ACCMA has compiled the following telemedicine resources for physicians needing guidance about telemedicine implementation:

CMA is working to obtain information on payor reimbursement policies related to COVID-19 and telemedicine/telephone appointments. As of now, the ACCMA is aware of the following policy announcements:

Guidance for Adopting Telemedicine Quickly

by David Ginsberg, PrivaPlan

During the novel coronavirus (COVID-19) emergency, physicians and healthcare providers may want to adopt telemedicine as a way to provide patient care. The following outlines some easy, acceptable practices for adopting telemedicine quickly that comply with HIPAA and California data and privacy laws, but some precautions should be followed. These include:

  • Ideally use a professional telemedicine platform. One such platform that is widely available is Zoom for Healthcare. If you will be recording and saving the telemedicine visits, be sure to have a HIPAA business associate agreement in place with the vendor.
  • If you don’t need to record the visit, you can use Facetime or WhatsApp, both of which encrypt the meeting; you can also use Skype or other video meeting technology.
  • Be sure that you follow all good HIPAA security practices, especially if you will provide this from your home computer or personal smartphone: 
    • Ensure Wi-Fi is secured with WPA2 encryption (fairly easy to do if not already – see article)
    • If working from home, work from as private an area as possible, and don’t allow family members or others to shoulder surf or see your workstation screens
    • Always log off when you get up and leave your workstation at home unattended – and this is not a screen saver, but a complete log-off
    • Don’t use sticky notes or otherwise leave your passwords visible near the workstation

While the President has waived HIPAA “enforcement” during this emergency, California data and security laws currently remain in effect; also, patients can still bring an action if their PHI or personal information is breached.

Today’s announcement also means that certain HIPAA Privacy requirements are not being enforced:

  • the requirements to obtain a patient's agreement to speak with family members or friends involved in the patient’s care. See 45 CFR 164.510(b)
  • the requirement to honor a request to opt out of the facility directory. See 45 CFR 164.510(a)
  • the requirement to distribute a notice of privacy practices. See 45 CFR 164.520
  • the patient's right to request privacy restrictions. See 45 CFR 164.522(a)
  • the patient's right to request confidential communications. See 45 CFR 164.522(b)

NOTE: The ACCMA does not endorse or have any relationship with any companies or products mentioned in this article.

For more information, ACCMA has recorded a Q&A podcast with David Ginsberg concerning HIPAA and COVID-19.

Small Businesses and Small Business Employees SBA Loans

Small businesses in Alameda and Contra Costa counties are among those eligible for the SBA’s Economic Injury Disaster Loan program, which provides small businesses with working capital loans of up to $2 million that can provide vital economic support to small businesses to help overcome the temporary loss of revenue they are experiencing. For more information and to apply for SBA loans, please visit the Disaster Loan website. Click here for the official announcement from the SBA.

Assistance for Sick/Quarantined Employees of Small Businesses

If you are an employee of a small business and are sick or quarantined you can apply for disability benefits. Please visit the California State Department of Employment Development website for more information. If you are an employee and have experienced reduced work hours you can apply for unemployment benefits.  

Payroll Tax Flexibility

Employers experiencing hardship as a result of COVID-19 may request up to a 60-day extension of time from the EDD to file their state payroll reports and/or deposit state payroll taxes without penalty or interest. A written request for an extension must be received within 60 days from the original delinquent date of the payment or return. For questions, employers may call the EDD Taxpayer Assistance Center.

Toll-free from the U.S. or Canada: 1-888-745-3886

Hearing-impaired (TTY): 1-800-547-9565

Outside the U.S. or Canada: 1-916-464-3502

We are waiting for more information regarding Federal Tax relief from the IRS. Taxpayers are encouraged to use www.irs.gov to find answers to their tax questions. Qualifying taxpayers can use the FreeFile program without cost.

Additional Resources

MIEC