The raging pandemic opened the floodgates for telehealth last year, more so after the addition of new options like audio-only service as part of the public health emergency. What was once limited largely to rural areas, coverage of telehealth services by traditional Medicare has undergone rapid expansion during the pandemic. A recent KFF analysis found that 1 in 4 Medicare beneficiaries had a telehealth visit with a doctor or other health professional between the summer and fall of 2020.
Medicare Advantage plans have been able to offer additional telehealth benefits not covered by traditional Medicare outside of the public health emergency. But this may not last forever. Coverage of telehealth services under traditional Medicare is expected to revert to the more limited availability when the public health emergency is lifted once the over-a-year-long pandemic ends.
If the Biden administration goes for the old telehealth coverage provisions post-pandemic, this may not augur well for the healthcare industry. Experts have long been saying that telehealth is here to stay. And a massive increase in its use during the year just goes to prove that.
To ensure continued access to these services, a slew of bills have already been introduced in Congress. Let’s have a look at some of the key Bills designed to make permanent much of the temporary telehealth coverage provisions.
1. Permanency for Audio-Only Telehealth Act
The most prominent among them is the Permanency for Audio-Only Telehealth Act. Introduced on December 18, 2020 by Congressmen Jason Smith and Tony Cardenas, the Act would allow CMS to reimburse Medicare providers for certain audio-only telehealth visits. The Act aims to permanently do away with technological and geographic barriers in rural areas like erratic broadband connectivity that doesn’t support audio-visual telemedicine technology. It will be a boon to the rural population. The Act has provisions for covering and reimbursing providers for evaluation and management services and mental and behavioral health services when extended via an audio-only telehealth platform.
2. Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act
In February, Senators Rob Portman and Sheldon Whitehouse introduced the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act to support the expansion of telehealth services for substance use disorder treatment. The bill would build upon the Trump Administration’s action to waive regulatory restrictions for accessing care in the wake of the COVID-19 pandemic. While the temporary waivers provide a necessary reprieve for patients so that they may continue their treatments and counseling virtually, they are time-limited and will ultimately expire at the conclusion of the Public Health Emergency.
The TREATS Act would extend these telehealth flexibilities by making permanent key waivers, including the ability to prescribe Medication-Assisted Therapies (MAT) and other necessary drugs without needing a prior in-person visit and the ability to bill Medicare for audio-only telehealth services. By taking these steps, the TREATS Act will increase overall access to MAT and support telehealth needs in rural communities where broadband may be needed.
3. Telehealth Modernization Act
The bipartisan Telehealth Modernization Act was re-introduced in the last week of February by Senators Tim Scott, Brian Schatz, and Jeanne Shaheen in an attempt to update coverage restrictions that have long prevented life-saving telehealth services for many of the nation’s roughly 61 million Medicare beneficiaries. The Act aims to make two provisions permanent. First, ensuring that patients can access telehealth anywhere by permanently removing Medicare’s “geographic and originating site” restrictions, which required both that the patient live in a rural area and use telehealth at a doctor’s office or certain other clinical sites. Secondly, it is designed to protect access to telehealth for patients in rural areas.
Additionally, the Act gives the Secretary of Health and Human Services new authority to help patients continue to access telehealth from physical therapists, speech-language pathologists, and other health care providers, give Medicare recipients many more telehealth services and help Medicare hospice and home dialysis patients use telehealth to keep receiving necessary care.
4. Expanded Telehealth Access Act
The Act was reintroduced on March 23 this year to increase access to telehealth services by expanding the list of the providers eligible for Medicare reimbursement for providing care via telehealth. In a bid to reduce any risks associated with visiting medical providers during the coronavirus pandemic, the Centers for Medicare & Medicaid Services expanded the types of health care providers who receive reimbursement for telehealth services. This Act aims to make permanent reimbursement eligibility for physical therapists, audiologists, occupational therapists, and speech-language pathologists and permits the Secretary of Health and Human Services to expand this list.
Conclusion: Expanding coverage of telehealth beyond the pandemic is an absolute necessity given that it has benefited mostly the disadvantaged population, like those with disabilities, with low incomes, and in communities of color. Policymakers have received wide support in their efforts to expand some or all of the existing flexibilities surrounding telehealth services even after the public health emergency comes to an end. The use of telehealth amid the pandemic has exhibited the critical role technology can play in improving health equity.