Bipartisan TIKES Act would improve telehealth access for kids

The legislation would require the HHS Secretary to issue guidance to states on virtual care strategies and mandate studies on the impact of telemedicine on healthcare access.

By Kat Jercich October 02, 2020 02:41 PM

This week, U.S. Reps Lisa Blunt Rochester, D-Del., and Dr. Michael C. Burgess, R-Texas, introduced legislation aimed at increasing telehealth access, particularly for children.  

The Telehealth Improvement for Kids’ Essential Services, or TIKES, Act of 2020 would require the Secretary of the U.S. Department of Health and Human Services to issue guidance to states about how to increase access to telehealth under Medicaid and the Children’s Health Insurance Program.   

It would also mandate a study on the impact of telehealth on healthcare access, utilization, cost and outcomes and would require the Comptroller General to submit a report evaluating collaboration between federal agencies with respect to telehealth services furnished under the Medicaid or CHIP program to those under the age of 18.  

“The COVID-19 pandemic has allowed for us to make rapid progress on expanding access to telehealth so children and families across the country, especially those in rural and underserved communities, face fewer barriers to accessing medical care,” said Rep. Blunt Rochester in a statement.

“With the introduction of the TIKES Act, we can continue that progress by bringing better alignment and clarity to Medicaid telehealth policies, as well as provide guidance to state Medicaid programs on the opportunities telehealth services can have for children,” Blunt Rochester continued.  

WHY IT MATTERS  

Pediatric health systems issued statements in support of the legislation, saying that it creates an opportunity for the federal government to provide more clarity to states regarding telehealth expansion.  

Such guidance, as mandated by the bill, would include technical assistance and best practices regarding:  

• Telehealth delivery of covered services.
• Recommended voluntary billing codes, modifiers and place-of-service designations for telehealth and other virtual health care services.
• The simplification or alignment of provider licensing, credentialing and enrollment protocols with respect to telehealth across states, state Medicaid plans and Medicaid managed care organizations.
• Existing strategies states can use to integrate telehealth and other virtual health care services into value-based health care models.
• Examples of states that have used waivers under the Medicaid program to test expanded access to telehealth.

“Telehealth has facilitated the delivery of high-quality, efficient care to millions of American children,” said Dr. R. Lawrence Moss, president and CEO of Nemours Children’s Health System, in a statement. “The public health challenge of COVID-19 highlighted its effectiveness and proved that it will be valuable as a permanent part of the U.S. healthcare system.”

Nemours operates hospitals in Delaware and Florida, as well as outpatient facilities in five states. According to its website, it offers video patient visits through Nemours CareConnect.  

Moss said that the easing of restrictions related to telehealth in light of the coronavirus pandemic “demonstrated how quickly policymakers, payers and providers can work together on behalf of patients and families.”  

“While providers across the country have taken swift action to ramp up telehealth capacity during the COVID-19 pandemic, we need long-term solutions to reduce barriers to provide safe and reliable care via telehealth,” said Carey Officer, operational vice president of Nemours Center Health Delivery Innovation, in a statement. 

The TIKES Act, Officer said, is one important step toward that goal.  

THE LARGER TREND  

Federal legislators have introduced several bills – many of them bipartisan – aimed at safeguarding access to virtual care after the COVID-19 pandemic.   

Several healthcare organizations and stakeholders rallied this July in favor of the Protecting Access to Post-COVID-19 Telehealth Act in the House, which would:   

• Eliminate most geographic and originating site restrictions on the use of telehealth in Medicare.
• Authorize the Centers for Medicare and Medicaid Service to continue reimbursement for telehealth for 90 days beyond the end of the public health emergency.
• Enable the HHS to expand telehealth in Medicare during all future emergencies and disasters, among other provisions.

That legislation has been referred to committee.   

“It’s a pretty exciting time for telehealth,” said Rep. Mike Thompson, D-Calif., at the time. “There’s a lot of enthusiasm for doing this.”  

Meanwhile, groups including the Connected Health initiative pushed the Senate to pass the Telehealth Modernization Act, introduced by Sen. Lamar Alexander, R-Tenn., this summer.  

Similarly, that legislation would amend Medicare originating site rules for telehealth to include a patient’s home and relax the geographic restrictions on telehealth provisions. It would also expand the types of practitioners eligible to furnish telehealth services and enhance telehealth services for federally qualified health centers and rural health centers, among other provisions. It has also been referred to committee.  

ON THE RECORD  
“Amidst the pain and suffering that our nation has endured throughout the COVID-19 pandemic, a major takeaway has been the advantage of telehealth. There is a convenience factor to not having to take time to physically transport yourself to the doctor’s office and have your child sit in a waiting room with other potentially sick patients,” said Rep. Burgess in a statement. 

“I urge my fellow members to support this legislation that will help build upon the telehealth foundation that we have built this year,” Burgess continued.