American Hospital Association voices support for telehealth expansion bill

Jeff Lagasse, Associate Editor

The American Hospital Association has come out in support of bipartisan legislation, introduced in the House of Representatives, that would require the Department of Health and Human Services, Medicare Payment Advisory Commission, and Medicaid and CHIP Payment and Access Commission to study expanded telehealth use during the COVID-19 pandemic and recommend potential enhancements to telehealth access and quality.

In a letter to Republican Ohio Representative Troy Balderson, the AHA said it backed H.R. 1110, the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act.

The legislation mandates that HHS, MedPAC and MACPAC each conduct a report and issue recommendations on telehealth. These reports will include the expansion of telehealth services during the COVID-19 outbreak, the uptake of those services by patients across the country, and recommendations for enhancing the quality of and access to these services. 

The bill also asks each entity to make recommendations for potential improvement and expansion, as well as approaches to address and prevent fraudulent activity.

Last week, Balderson said this data is “crucial” for Congress to legislate a permanent expansion of telehealth.

“Telehealth is helping to better connect patients and providers by reducing the need for long-distance travel for routine in-person care and consultations,” said Balderson, who introduced the bill along with Representatives Susie Lee (D-NV), Ashley Hinsno (R-IA) and Joe Neguse (D-CO).

The AHA concurred.

“Telehealth has provided a critical way for patients to continue to access needed care, particularly during the COVID-19 pandemic,” the organization wrote in its letter. “We greatly appreciate the flexibilities implemented during the public health emergency and recently extended through 2024, as they will allow hospitals and health systems to continue to provide virtual care for patients.”


In order to help beneficiaries maintain access to care amid stay-at-home orders aimed at reducing COVID-19 related exposure, the Centers for Medicare and Medicaid Services used emergency waiver authorities enacted by Congress, as well as existing regulatory authorities, to implement policies expanding access to telehealth services during the pandemic.

These included waiving several statutory limitations, such as geographic restrictions, and allowing beneficiaries to receive telehealth in their home. 

The omnibus spending package that passed in December extended telehealth – and hospital-at-home programs – beyond the end of the public health emergency. The legislation extends waivers for both programs. Telehealth flexibilities are now in effect through the end of 2024.

Outside of the public health emergency, Medicare is generally restricted to payment for telehealth services in certain, mostly rural areas, and when beneficiaries leave the home and go to a clinic, hospital or other medical facility for the service.

In the physician fee schedule rule released in November, CMS announced that for the first time outside of the COVID-19 PHE that Medicare would pay for mental health visits furnished by Rural Health Clinics and Federally Qualified Health Centers via interactive video-based telehealth, including audio-only telephone calls.


In October 2022, after three months of relative stability, national telehealth utilization declined 3.7%. Looking at one specific metric, telehealth went from 5.4% of medical claim lines in September, to 5.2% in October, according to FAIR Health’s Monthly Telehealth Regional Tracker.

The decline in telehealth utilization was larger than the national average in the South (6.8%), Midwest (4.9%) and West (4.1 %), while there was an increase in utilization of 1.7% in the Northeast.

The data represents the privately insured population, including Medicare Advantage and excluding fee-for-service Medicare and Medicaid.