Healthcare industry groups are pushing congressional leaders to pass new legislation that will permanently expand telehealth flexibilities.
Action is needed to ensure patients and clinicians don't fall off the "telehealth cliff" when the COVID-19 public health emergency ends, according to a letter (PDF) signed by 340 physician groups and industry associations.
If Congress does not act before the COVID-19 public health emergency expires, current flexibilities will immediately disappear, said the industry groups in a letter sent to Senate Majority Leader Mitch McConnell, R-Kentucky, House Speaker Nancy Pelosi, D-California, Senate Minority Leader Charles Schumer, D- New York, and House Minority Leader Kevin McCarthy, R-California.
Congress quickly waived statutory barriers to allow for expanded access to telehealth at the beginning of the COVID-19 pandemic, providing federal agencies with the flexibility to allow healthcare providers to deliver care virtually.
While federal agencies can address some of these policies going forward, the Centers for Medicare & Medicaid Services (CMS) does not have the authority to make changes to Medicare reimbursement policy for telehealth under the outdated Section 1834(m) of the Social Security Act, the groups said.
Organizations signing the letter include the American Academy of Family Physicians, the American Telemedicine Association, the Alliance for Connected Care, the Primary Care Collaborative, the American College of Physicians, AMGA and the College of Healthcare Information Management Executives
Technology companies also signed the letter including Epic, Cerner, Allscripts and Google.
Providers across the country have utilized recent policy flexibilities to scale delivery and provide older Americans, many for the first time, access to high-quality virtual care, resulting in 11.3 million beneficiaries accessing telehealth services in mid-April alone, according to the letter.
Additional flexibility has also allowed federally qualified health centers to deliver safe and effective care to underserved patient populations that have rated the service they received highly
Private health plans have also followed suit, and in response, telehealth adoption has soared—resulting in a 4,300% year-over-year increase in claims for March 2020, the groups said in the letter, citing data from Fair Health.
Taken as a whole, these temporary policy changes have allowed 46% of Americans to replace a canceled healthcare visit with a telehealth service during the pandemic.
"Virtual care has provided unprecedented access for patients, but it has become clear that uncertainty as to the future of telehealth under Medicare will halt or reverse further adoption and utilization—to the detriment of both patients and providers," the groups wrote.
Congress must act to ensure that the HHS Secretary has the appropriate flexibility to assess, transition, and codify any of the recent COVID-19-related telehealth flexibilities and ensure telehealth is regulated the same as in-person services.
The healthcare groups said congressional leaders also have the responsibility to ensure that billions of dollars in COVID-19-focused investments made during the pandemic are not wasted and instead used to support the transformation of care delivery.
Here are the steps Congress should immediately take, according to the 340 groups:
- Remove obsolete restrictions on the location of the patient. The industry groups would like to see Congress permanently remove the current section 1834(m) geographic and originating site restrictions to ensure that all patients can access care at home and other appropriate locations. This would allow beneficiaries across the country to receive virtual care in their homes or a location of their choosing, where clinically appropriate and with beneficiary protections and guardrails in place.
- Maintain and enhance HHS authority to determine appropriate providers and services for telehealth. The HHS Secretary needs to have the flexibility to expand the list of eligible practitioners who may furnish clinically appropriate telehealth services. Similarly, HHS and CMS should maintain the authority to add or remove eligible telehealth services—as supported by data and demonstrated to be safe, effective, and clinically appropriate—through a predictable regulatory process that gives patients and providers transparency and clarity.
- Ensure federally qualified health centers and rural health clinics can furnish telehealth services after the public health emergency. Congress should ensure that these facilities can offer virtual services post-COVID and work with stakeholders to support fair and appropriate reimbursement for these key safety net providers
- Make permanent HHS temporary waiver authority for future emergencies. The industry groups want HHS and CMS to have the authority to act quickly during future pandemics and natural disasters.
"Swift congressional action will provide a clear signal to patients, who are concerned about the future of their telehealth benefits, as well as providers and health systems, which are hesitant to make investments in critical healthcare infrastructure without certainty from policymakers," the industry organizations wrote in the letter.