Page 9 - 2020 Summer CMTA Report

recipients to have available a Dr. Mario Saporta,
flashlight, a safety pin or paper
clip for testing pinprick sensations, director of University of
a cotton ball or Q-tips to test light Miami’s CMTA Center
touch sensations, a card or coin to
test hand dexterity and strength, a for Excellence says the
plastic cup or glass and a blood clinic’s format is much
pressure monitor.
They are also asked to have a the same as it was
caregiver or family members pre- pre-pandemic.
sent during the assessment to help
with things like the pin prick tests. and Medicaid Services is no longer half the clinic’s patients do. The
Dr. Saporta jokes that he awards enforcing a requirement that platform works particularly well
those helpers honorary neurology patients have an established rela- for CMT, he said, because it is a
degrees. tionship with a physician in order slowly progressive chronic condi-
Saporta said his team is also to receive telehealth. Most health tion, as opposed to a something
experimenting with using “telere- insurance companies including like MS where patients have sud-
habilitation” in which therapists Aetna, Cigna and UnitedHealth- den, acute flare-ups. “It’s very rare
assess functional ability and weak- Care are covering virtual visits for CMT patients to throw us a As The CMTA Report
goes to press, some
ness progression, then devise a during the pandemic. curveball,” he added. states and insurers
rehabilitation plan for the patient. Saporta believes that tele- All in all, Saporta said, “Given are beginning to
“The rest is education,” he said. health is here to stay. Patients seem the constraints we are facing the restrict telemedicine
While telemedicine can’t to like it, he said, particularly system works very well at keeping appointments.
accomplish genetic testing, kits those who come from more than both patient and doctor healthy Before you arrange
one, check to make
can be sent to patients with three hours away, as more than and safe.” h sure it’s covered.
instructions for taking mouth
swabs or saliva samples, which can
then be mailed directly to the
genetic laboratory. And because SIX CENTERS OF EXCELLENCE
genetic testing labs operate sepa- SURVEYED
rately from other testing labs,
they’ve not been overwhelmed n informal survey of six other Centers of Excellence revealed that all of them have
with testing for the coronavirus. A moved to telemedicine appointments since the pandemic began. The respondents were
The complex web of insur- Dr. Kevin Felice with the Hospital for Special Care, Dr. Raghav Govindarajan from the
ance and regulatory issues to University of Missouri–Columbia, Dr. Ryan Jacobson at Rush University in Chicago,
permit telehealth have largely been Dr. Jun Li at Wayne State, Dr. Rebecca Traub at UNC Chapel Hill and Dr. Sasa Zivkovic
resolved at this point. HIPAA (the at the University of Pittsburgh.
Health Insurance Portability and Only two of the respondents had ever done telemedicine appointments before the
Accountability Act of 1996) regu- pandemic began: one had done a few telemedicine appointments, though not for CMT
lations were relaxed in March to patients and one had previously done inpatient video consults. Four of the six had zero
allow providers to use virtual plat- experience with telemedicine up to that point.
forms like Zoom and Skype for Appointments covered a wide variety of subjects, including diagnosis, genetic testing
visits with patients. After the pan- and counseling, reviewing test results, disease progression, adjusting medication for symp-
demic was declared a national tom management and pain management. The doctors found it very helpful to observe
emergency on March 13, the U.S. patients walking and standing in their home environment in order to assess their current
Department of Health and needs. They also praised telemedicine for the convenience it offers patients, particularly
Human Services waived federal those at high risk for coronavirus and those who have to travel long distances.
licensing regulations to permit Obviously, not everything can be covered in a telemedicine appointment.
out-of-state physicians to treat Respondents cited as examples EMG and NCT tests, the difficulty in performing
patients via telemedicine. a good neurological examination, PT and OT assessments, orthotics assessments and
Telemedicine visits are now anything that requires a detailed exam.
covered by Medicare regardless of All six plan to continue telemedicine appointments, subject to insurance carriers
whether the patient lives in a rural continuing to cover them.
area and the Centers for Medicare

SUMMER 2020 THE CMTA REPORT 9