State officials are urging the federal government to waive restrictions that prevent nonprofit health clinics from getting paid for providing care by telephone to Medi-Cal patients.
Many medical centers are encouraging patients to utilize telehealth services to keep them from overcrowding facilities which could stress the system and increase the risk of coronavirus transmission. But the government-funded health insurance that many low-income patients rely on does not pay providers for appointments that don't happen face-to-face.
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That means health clinics like the nonprofit Family Health Centers of San Diego won't receive payment for the nearly 300 daily telehealth appointments it began providing since the global outbreak reached San Diego County.
Family Health Centers of San Diego CEO Fran Butler-Cohen said the facility is losing money while it tries keep as many patients as possible from physically visiting the system's more than two dozen primary care locations.
"Every activity that we make with a patient over the phone — assessment, medical advice, diagnosing, prescriptions — none of that is reimbursable at this point because the patient is not physically in the site," Butler-Cohen said, "which everybody is saying keep the patients out of the sites as much as possible."
She said treating patients at the primary care level can keep their ailment from progressing to a point where they need to visit emergency departments, which are already stressed during the public health emergency.
The Department of Health Care Services this week requested the federal government waive the requirement of in-person care and allow telehealth treatment.
In a statement, Gov. Gavin Newsom said the move is necessary considering the current situation.
“To get Californians the care they need during this crisis, we need to change how that care is delivered and communicated," he said, according to Tuesday news release on his website. "By expanding our telehealth options we’re minimizing disruption to our health care system to prioritize care for those who need it most, while providing easier, more accessible options for other Californians seeking care.”
President Donald Trump previously expanded telehealth coverage under Medicare, which is soley funded by the federal government and serves those 65 years or older. However, the administration has not yet approved it for Medicaid, which in California is called Medi-Cal and funded by the state and federal governments.
