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Welcome to the Why Urology podcast with Dr. Todd Brandt.

This podcast is my personal attempt to teach you about your genito-urinary tract, what can go wrong, and how your urologist may just become your superhero.

The name of the podcast comes from my ongoing need to answer the question that I get so often from patients, friends, and family, “Why Urology? Why did you choose to become a urologist?”

Mar 26, 2020

The Centers for Medicare and Medicaid services uses the terms telehealth, telemedicine, and related terms generally refer to the exchange of medical information from one site to another through electronic communication to improve a patient’s health. 

Telehealth applications include:

  1. Live (synchronous) videoconferencing: a two-way audiovisual link between a patient and a care provider
  2. Store-and-forward (asynchronous) videoconferencing: transmission of a recorded health history to a health practitioner, usually a specialist.
  3. Remote patient monitoring (RPM): the use of connected electronic tools to record personal health and medical data in one location for review by a provider in another location, usually at a different time.
  4. Mobile health (mHealth): health care and public health information provided through mobile devices. The information may include general educational information, targeted texts, and notifications about disease outbreaks.

The Coronavirus Preparedness and Response Supplemental Appropriations Act, was signed into law by the President on March 6, 2020, declared an 1135 waiver on telehealth services during the covid- 19 crisis. Essentially this allows for clinic visits to be done via videoconferencing between patient and physician during the crisis, allowing the physician to bill for the services at the same level that they would an in-office clinic visit. This allows for both the delivery of services to patients in need but also allows physician offices, many of them small independent business to maintain a revenue stream during the crisis.

I welcome this change because I have long thought that many of the services we deliver to patients should not require them to drive to the office, check in at the front desk, wait in the waiting room, and then sitting in an exam room for multiple minutes prior to a short visit to follow up on labs, or an x-ray review, or get some education, or discuss a medical problem that does not require a physical exam.

When the President expanded the use of telehealth he used what is called an 1135 waiver. When the President declares a disaster or emergency under the Stafford Act or National Emergencies Act and the HHS Secretary declares a public health emergency under Section 319 of the Public Health Service Act, the Secretary is authorized to take certain actions. For example, under section 1135 of the Social Security Act, a secretary, or in this case the President, may temporarily waive or modify certain Medicare, Medicaid, and Children’s Health Insurance Program requirements to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in Social Security Act programs. These 1135 waivers typically are time limited, ending no later than the termination of the emergency period, or 60 days from the date the waiver.

The current 1135 waiver for covid-19 allows Medicare to pay for office, hospital, and other visits furnished via telehealth across the country and including in patient’s places of residence starting March 6, 2020.

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