The chairman of the Senate Committee on Health, Education, Labor and Pensions (HELP) made clear this week during a hearing that he wants Congress to make permanent changes this year to allow telehealth visits to take place in the home, instead of an originating site such as a physician’s office, and to maintain expanded coverage of the types of services that CMS will cover via telehealth.
Remarking that Congress should take advantage of the fact that the healthcare system saw “10 years of telehealth experience crammed into three months,” Sen. Lamar Alexander of Tennessee also said the relaxed requirements that allowed doctors to use common video and phone apps were important to the expanded adoption of telehealth. But, Alexander noted, Congress should approach privacy issues carefully.
In early March, CMS started issuing a flurry of changes to make telehealth more widely available to protect vulnerable populations from exposure to COVID-19, including increasing payment to reimburse for telehealth the same as an in-person visit, expanding the patient pool for telehealth and allowing it to be used for emergency department visits, initial nursing facility visits and discharges, and therapy services, among other things.
Senators on the committee expressed concern about broadband access and connectivity challenges in rural areas, with some witnesses saying they want to preserve access to audio-only options for that reason.
Experts, particularly from providers, encouraged Congress to lift reimbursement barriers. “As a healthcare system, it’s hard to stand up an expansive telehealth program with multiple different payers covering different services,” said Dr. Karen S. Rheuban, director of the Center for Telehealth at the University of Virginia.” As much harmonization as possible would be a huge incentive for adoption and expansion.”
Sen. Mike Braun of Indiana said that while pricing parity may make sense during a public health emergency, he wouldn’t want that in the future because he wants to see telehealth used to bring efficiency and cost savings.
Payers, providers and employers have been watching for signs from Congress as they build out their telehealth operations, wondering if they should plan for an entirely new healthcare delivery system where virtual health continues to play an important role, even post-pandemic, or expect the traditional barriers to be erected again. The Trump administration, especially CMS Administrator Seema Verma, has indicated support for retaining some of the telehealth changes.
A bipartisan group of 30 senators wrote a letter to Senate leadership this week asking that some telehealth provisions be made permanent. “Congress should expand access to telehealth services on a permanent basis so that telehealth remains an option for all Medicare beneficiaries both now and after the pandemic,” they wrote. “Doing so would assure patients that their care will not be interrupted when the pandemic ends. It would also provide certainty to health care providers that the costs to prepare for and use telehealth would be a sound long-term investment.”
Some members have introduced their own telehealth-related bills.
In a new report launched this week, HRI takes a closer look at how COVID-19 has and will continue to accelerate changes in healthcare delivery, including through virtual health.