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ACOG Gains Ground on Expanding Telehealth

As part of ACOG’s ongoing advocacy efforts to ensure expanded access to telehealth services, we endorsed the Protecting Access to Post-COVID-19 Telehealth Act of 2020 H.R. (7663). This bill, endorsed by the House Telehealth Caucus with bipartisan support, would remove outdated Medicare restrictions on telehealth, and expand coverage after the COVID-19 public health emergency (PHE) ends. This ensures obstetrician-gynecologists can continue utilizing the telehealth services to provide safe, quality health care for your patients. 

Specifically, H.R. 7663 would:

  • Remove geographic restrictions on patient location for telehealth services so that all Medicare beneficiaries can access covered telehealth services
  • Enable all Medicare beneficiaries to receive telehealth services from their homes
  • Ensure federally qualified health centers and rural health centers are able to furnish telehealth services

As efforts to expand telehealth access gain momentum on Capitol Hill, the President also signed an Executive Order (E.O.) on Improving Rural Health and Telehealth Access. The E.O. calls on HHS to propose regulations to make permanent many of the telehealth services currently available due to the flexibilities allowed during the PHE, including E/M services for patients in the home. The Centers for Medicare and Medicaid Services (CMS) subsequently released the CY 2021 Medicare Physician Fee Schedule proposed rule, in which it has included proposed changes to expand certain telehealth services permanently. ACOG is still reviewing the Physician Fee Schedule telehealth proposals  released this week, and we will continue advocating to expand covered telehealth services for your patients. We will be submitting public comments in October on the proposed rule that outlines the telehealth services CMS should make permanent. 

Over the course of the PHE, ACOG has called on the Administration and private payers to permanently expand access to telehealth services for women. We recently wrote to HHS and CMS urging them to continue covering audio-only telehealth services, permanently implement payment parity, and improve access to remote patient monitoring services for pregnant and postpartum women. And ACOG continues pushing the nation’s major private payers to maintain their expanded telehealth policies. After writing to and meeting with major private insurers, several have announced plans to extend their COVID-19 telehealth coverage policies and are re-evaluating their standard telehealth coverage benefits and payment policies. We previously reported some of our wins that resulted from this advocacy with private payers, and below are some more recent updates:

Cigna has extended their telehealth policy through at least December 31, 2020:

  • Coverage of audio-only E/M visits.
  • Telehealth visits, both audio-video and audio-only, will be paid at parity with in-person visits.
  • Coverage of a 5-10-minute phone consults using HCPCS code G2012, member cost-sharing for this service is waived.

Aetna has extended their telehealth policy through at least December 31, 2020:

  • Coverage of audio-only E/M visits.
  • Telehealth visits, both audio-video and audio-only, will be paid at parity with in-person visits. 
  • Physicians will be paid for both portions of a well-woman visit when they are rendered partially via telehealth and partially in person: Aetna will reimburse a telehealth evaluation and management service for the telehealth portion of the wellness visit in addition to the preventive medicine code, which should be used when the remaining parts of the visit are completed in the office.

We must maintain the progress made during the PHE to ensure telehealth stays widely accessible, and ACOG will continue our comprehensive advocacy campaign for our Members and your patients.