A new bipartisan House bill would ensure beneficiaries in Medicare Advantage (MA) plans can get access to audio-only telehealth services, a major ask from insurers.
The bill, introduced Tuesday, aims to build on flexibilities given to providers by the Centers for Medicare & Medicaid Services (CMS) to reimburse for telehealth services in light of the COVID-19 pandemic.
Currently, CMS allows providers to offer telehealth services under MA plans but only if a video component is included. However, a video option may not be available for lower-income or rural patients, a release on the bill said.
The Ensuring Parity in MA and PACE for Audio-Only Telehealth Act will change that and enable providers to offer audio-only telehealth. The bill would also require MA plans to reimburse providers for audio-only telehealth as if the visits were in person unless both parties agree to a separate policy.
“This will ensure that patients are not forced to forego critical care during the pandemic, as many of our seniors live in rural areas without access to broadband speeds that support video connections,” said Rep. Terri Sewell, D-Alabama, in a statement.
Sewell is one of the co-sponsors of the legislation alongside Reps. Gus Bilirakis, R-Florida; Tony Cardenas, D-California; Brian Fitzpatrick, R-Pennsylvania; Chrissy Houlahan, D-Pennsylvania; Ron Kind, D-Wisconsin; Jason Smith, R-Missouri; and Jackie Walorski, R-Indiana.
The legislation earned major plaudits from insurers and advocacy groups.
“Medicare Advantage must be equipped to meet beneficiaries where they are by allowing access to care through a simple phone call where appropriate or when beneficiaries lack other technological means,” said Allyson Schwartz, president of the Better Medicare Alliance, an advocacy group that presses Congress to pass policies that boost the MA program.
Top insurer lobbying group America’s Health Insurance Plans (AHIP) also lauded the legislation, saying many rural communities lack broadband service.
“Lawmakers have recognized the importance of telehealth, and this important legislation recognizes that for many seniors, a phone call is their only option for healthcare at home,” said AHIP President and CEO Matt Eyles in a statement.
Payers and providers will also need Congress’ help to fully extend some of the flexibilities CMS has given during the pandemic. Currently, several flexibilities, including originating site requirements, are likely to expire by the end of the pandemic’s public health emergency period, which will probably run through the rest of this year.