In a letter submitted to the Senate Finance Subcommittee on Health for a hearing Nov. 14, the AHA expressed support for the CONNECT Act (S.2016/H.R. 4189) and urged Congress to allow Medicare beneficiaries to access telehealth services wherever they and their providers are and allow rural health clinics, federally qualified health centers and critical access hospitals to serve as distance sites. AHA also encouraged Congress to: expand eligible telehealth providers to include occupational and physical therapists, speech-language pathologists and audiologists; no longer require beneficiaries to receive an in-person evaluation six months before and annually after initiating behavioral telehealth treatment; explicitly cover audio-only services; allow providers to use telehealth services to recertify hospice patients; and streamline licensure requirements for providers operating across state lines.
 
Testifying at the hearing were representatives from: the Northwest Regional Telehealth Resource Center; University of Alabama at Birmingham; University of Michigan; and Harvard Medical School.

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AHA on Oct. 10 voiced support for the CONNECT for Health Act (S. 2016/H.R. 4189), legislation that would increase patient access to telehealth services while removing barriers to adoption. The bill would permanently remove geographic restrictions that limit where patients can access telehealth, add homes and other clinically appropriate originating sites, and allow rural health clinics and federally qualified health centers to serve as distant sites. It also would remove requirements for an in-person evaluation six months before initiating behavioral telehealth treatment and an in-person visit annually thereafter.

AHA encouraged the legislation’s House and Senate sponsors to consider eliminating restrictions on originating sites altogether, and allowing critical access hospitals to offer and bill for telehealth services and serve as distant sites.

“Hospitals, health systems, providers and patients have seen the benefits and potential for telehealth to increase access and transform care delivery,” AHA wrote. “We appreciate your leadership on this important issue and look forward to working together to ensure passage of the CONNECT for Health Act of 2023.”

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Telehealth changes that helped physicians and patients during the COVID-19 pandemic could become permanent under a new bill pending in Congress.

Meanwhile, another leading physician group is supporting site-neutral payment for medical services. The two issues have sparked renewed discussion this month due to proposals by federal policy makers.

CONNECT in Congress

A bipartisan group of 60 senators have reintroduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023.

U.S. Sen. Brian Schatz, D-Hawaii, said the legislation is becoming urgent because telehealth provisions allowed during the pandemic were continued through 2024, but they will expire.

“While telehealth use has skyrocketed these last few years, our laws have not kept up. Telehealth is helping people in every part of the country get the care they need, and it’s here to stay,” Schatz said in his announcement of the legislation. “Our comprehensive bill makes it easier for more people to see their doctors no matter where they live.”

Pre-pandemic help

Much of the CONNECT Act predates the pandemic – it was first introduced in 2016 and some of its rules have been implemented, according to the senators. For example, physicians have greater ability to used telehealth for mental health services, stroke care, and home dialysis.

Still needed are allowances such as removing geographic restrictions on telehealth services and expanding originating sites to include homes. Health centers, rural health clinics, and other eligible health care professionals also could provide telehealth.

The bill would require more study of how telehealth is used, how it affects quality of care, and how to improve it.

“Telehealth is a revolutionary development in health care delivery. The Internet put communications and commerce in the palm of our hand, and it is now doing the same for health care,” cosponsor Sen. Roger Wicker, R-Mississippi, said in a statement. “After years of dedicated efforts, I am pleased to see the growing support for making flexibility in telehealth delivery permanent. The CONNECT for Health Act will move us toward Medicare beneficiaries receiving the healthcare they deserve.”

A number of physician and other health care groups are supporting the CONNECT Act.

Conflicting views on telehealth

The bill was announced the same day as the 2023 report to Congress of the Medicare Payment Advisory Commission (MedPAC). It did not make a formal recommendation about Medicare’s future handling of telehealth services, but did repeat its March 2021 argument that the U.S. Centers for Medicare & Medicaid Services should resume paying lower rates for telehealth services “as soon as practicable after the PHE,” the COVID-19 public health emergency that ended May 11.

That is the wrong approach, according to the American College of Physicians (ACP), which shared a response with Medical Economics. Its members are “very concerned” about potential reductions in payments for telehealth services.

“Over the COVID-19 public health emergency, we saw a large uptick in the number of services provided by telehealth,” the ACP statement said. “Expanding the role of telehealth as a method of health care delivery has the potential to enhance patient-physician collaboration, improve health outcomes, increase access to care, as well as access to members of a patient’s health care team, and reduce medical costs. Reducing reimbursement for these services will diminish the potential of this important means of health care delivery.”

Site-neutral payment

As for in-person health, ACP supported MedPAC’s recommendation to Congress for site-neutral payments for physicians, instead of payment tiers based on the location of health services.

“There is no justification for patients and the Medicare program paying more for a visit when the service is provided in an office owned by a hospital than for the same type of visit in an independent physician practice,” the ACP statement said. “Adding fees to services based merely on who owns the facility where the service is performed in no way reflects the value of services provided.”

The issue has become divisive within health care. Patients have complained publicly about higher costs to them due to service prices based on location. Hospitals counter that greater reimbursement helps them cover costs that physicians’ offices don’t have. The American Hospital Association has argued site-neutral payment would hurt rural hospitals, making an average negative operating margin even worse.

ACP and the American Academy of Family Physicians both are part of the Alliance for Site Neutral Payment Reform, a coalition of “patient advocates, providers, payers, and employers who support payment parity” regardless of location.

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Dive Brief:

• Telehealth groups are cheering after a bipartisan group of 60 senators reintroduced the CONNECT for Health Act last week, which would make pandemic-era virtual care flexibilities permanent if passed.
• It’s the second time the bill has been reintroduced in Congress as proponents of virtual care look to solidify COVID-19 gains in telehealth accessibility and use before temporary flexibilities run out at the end of 2024.
• Companion legislation has also been introduced in the House.

Dive Insight:

Permanently expanding telemedicine access has broad bipartisan support in Congress. A number of bills have been introduced to codify more telehealth protections after COVID-19, including CONNECT, which is considered the most comprehensive virtual care legislation by advocacy groups.

Since CONNECT was first introduced in 2016, a number of the bill’s original provisions have been enacted into law or adopted as policy by the CMS, including in the early days of the COVID-19 pandemic as Washington threw open the doors to broader telehealth use. Then a 2022 spending package extended a number of the changes through Dec. 31, 2024, giving regulators and Congress more time to analyze telehealth efficacy in Medicare and make any desired COVID-era changes permanent.

The updated CONNECT act would permanently remove geographic restrictions on telehealth services, expand originating sites to include the home and permanently allow health centers and rural health clinics to provide telehealth. It would also remove the six-month in-person visit requirement for telemental healthcare and permanently allow telehealth restrictions to be waived during public health emergencies.

CONNECT is endorsed by more than 150 industry organizations, according to the office of Sen. Brian Schatz, D-Hawaii, who led reintroduction of the bill.

Telehealth groups including Telehealth Access for America, the American Telemedicine Association and the College of Healthcare Information Management Executives came out with statements applauding legislators for the bill’s reintroduction.

“Telehealth is an issue that has consistently attracted bipartisan, bicameral support and we are very encouraged at the incredibly strong Congressional show of support, to this day,” said Kyle Zebley, ATA’s head of public policy.

Proponents argue that enshrining heightened access to telehealth will preserve continuity of care while removing obstacles many patients face in accessing services, including the cost and distance of travel.

Studies suggest that older adults and people from underserved communities benefited the most from expanded telehealth access during the pandemic, and that telehealth doesn’t contribute to duplicative care, as some feared, but instead acts as a substitute. However, overall research on that is mixed, as some studies have found telehealth increases overall utilization.

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What’s the news: A bipartisan group of 60 senators has reintroduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act. The CONNECT for Health Act, S. 2016, will expand coverage of telehealth services through Medicare, make permanent COVID-19 telehealth flexibilities, improve health outcomes, and make it easier for patients to connect with their doctors.

Protecting telehealth

Comprehensive telehealth reform is critical to the future of health care. The AMA is fighting for legislation to permanently remove restrictions on telehealth coverage and payment.

Learn About Our Advocacy

The updated version of the CONNECT for Health Act includes new and revised provisions that will help more people access telehealth services. Reintroduction of the bill was led by Sens. Brian Schatz, D-Hawaii, Roger Wicker, R-Miss., Ben Cardin, D-Md., John Thune, R-S.D., Mark Warner, D-Va., and Cindy Hyde-Smith, R-Miss.

Specifically, the legislation would:

• Permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and, by 2025, any other site that is deemed clinically appropriate for the service.
• Permanently allow health centers and rural health clinics to provide telehealth services.
• Remove unnecessary in-person visit requirement for telemental health services.
• Allow for the waiver of telehealth restrictions during public health emergencies.

Related Coverage

Get up to speed on big wins to ensure that telehealth is covered

Why it’s important: Last December, Schatz, Wicker and California Rep. Mike Thompson helped secure the inclusion of provisions from the CONNECT for Health Act to the 2023 fiscal year government funding bill that temporarily extended access to expanded telehealth services. Those provisions are set to expire in 2025, making the need for permanent telehealth policy even more urgent.

Since the onset of the COVID-19 pandemic, telehealth has been “an integral, indispensable tool for providing patient care, and it is vital that we maintain and build on the gains made over the past few years,” said AMA President Jesse M. Ehrenfeld, MD, MPH. The AMA is one of more than 150 organizations supporting the bill.

“Medicare coverage of telehealth offers immense opportunities to create better access to health care for rural and other underserved communities, reduces travel time, and serves as a vital tool for patients to receive seamless care with their existing physicians,” Dr. Ehrenfeld added. “Permanently extending telehealth coverage will benefit physicians and patients far and wide, ushering in a new era of patient care. We deeply appreciate Sens. Schatz, Wicker, Cardin, Thune, Warner and Hyde-Smith for their continued leadership on the CONNECT for Health Act of 2023.”

Supporting telehealth is an essential component of the AMA Recovery Plan for America’s Physicians.

Telehealth is critical to the future of health care, which is why the AMA continues to lead the charge to aggressively expand telehealth policy, research and resources to ensure physician practice sustainability and fair payment.

Related Coverage

7 telehealth trends that physicians should know

Learn more: Data shows that telehealth provides essential access to care with nearly one-quarter of Americans accessing telehealth in the past month.

The CONNECT for Health Act was first introduced in 2016 and since then several of its provisions were enacted into law or adopted by the Centers for Medicare & Medicaid Services, including the removal of restrictions on telehealth services for mental health, stroke care and home dialysis. 

Companion bipartisan legislation, H.R. 4189, has been introduced in the House by Democratic Reps. Thompson and Doris Matsui of California and Republicans David Schweikert of Arizona and Bill Johnson of Ohio. 

Visit AMA Advocacy in Action to find out what’s at stake in supporting telehealth and other advocacy priorities the AMA is actively working on.

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June 16, 2023 – In support of continued telehealth access, a bipartisan group of 60 United States senators reintroduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act to expand Medicare coverage of telehealth, sustain virtual care flexibilities, enhance health outcomes, and ease healthcare communication.

The COVID-19 pandemic highlighted the efficacy of telehealth. Greater telehealth use was made possible during the pandemic due to numerous regulatory flexibilities. But these flexibilities were intended to be temporary.

Initially introduced in 2016, lawmakers have since enacted various provisions of the CONNECT for Health Act into law. In 2020, three provisions from the CONNECT for Health Act became law. This led patients to use telehealth more, highlighting virtual care’s capabilities in improving care access.

Dig Deeper

• Legislation Aims to Maintain Virtual Access to Physical Therapy
• Legislation Aims to Support Telehealth Access in Rural Areas
• Legislation Aims to Support Telemental Health Services for Medicare

In December, Sen. Brian Schatz (D-Hawai‘i), along with other lawmakers, further secured provisions from this legislation. The 2022 year-end spending bill for 2023 included provisions to extend pandemic-era telehealth and hospital-at-home waivers through Dec. 31, 2024. Given the projected expiration date, there is an urgent need to place permanence on telehealth flexibilities, a press release from Schatz’s office notes.

Alongside Sens. Roger Wicker (R-Miss.), Ben Cardin (D-Md.), John Thune (R-S.D.), Mark Warner (D-Va.) and Cindy Hyde-Smith (R-Miss.), and many other senators, Schatz reintroduced the CONNECT for Health Act.

The reintroduced bill makes permanent various allowances surrounding virtual care. These include removing geographic restrictions on originating sites for telehealth, allowing health centers and rural health clinics to use telehealth, and increasing the list of professionals who can use telehealth. Other changes include waiving the need to initially participate in an in-person visit for mental healthcare, removing telehealth barriers during a public health emergency, and increasing published data requirements surrounding telehealth, its use, and its impact on care quality.

“While telehealth use has skyrocketed these last few years, our laws have not kept up. Telehealth is helping people in every part of the country get the care they need, and it’s here to stay,” said Schatz in a press release. “Our comprehensive bill makes it easier for more people to see their doctors no matter where they live.”

This effort has gained the support of over 150 organizations, including AARP, the American Telemedicine Association (ATA), Kaiser Permanente, and the National Association of Rural Health Clinics.

“Since originally introduced in 2016, the CONNECT for Health Act has envisioned a world where Medicare beneficiaries have access to virtual care services where and when they need them. Today, our esteemed policy champions in Congress reintroduced an updated version of the CONNECT Act, including new and revised provisions that will help more people access telehealth services,” said Kyle Zebley, senior vice president of public policy at the ATA, and executive director, ATA Action, in a press release shared with mHealthIntelligence.

The College of Healthcare Information Management Executives (CHIME) also showed support for the CONNECT for Health Act.

“The CONNECT for Health Act will ensure patients continue to have ongoing access to their clinicians; removing many obstacles some patients face accessing needed services while putting protections in place to ensure federal resources are effectively used,” said CHIME President and CEO Russ Branzell in a press release shared with mHealthIntelligence. “CHIME is pleased to see the legislation expand originating sites to include the home and other sites, allow more healthcare professionals to deliver care virtually, and repeal the unnecessary in-person visit requirement for telemental health visits. 

Legislation supporting telehealth service growth and application has accelerated in the last year.

In February, six US House representatives introduced the Telehealth Benefit Expansion for Workers Act. This bipartisan legislation aims to provide American workers with standalone employer-sponsored telehealth benefits.

Through this legislation, telehealth benefits would work similarly to dental and vision benefits. US Rep. Tim Walberg (MI-07) noted that the pandemic emphasized the efficacy and usefulness of telehealth and that expansion would improve healthcare access.

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The CONNECT For Health Act has been filed again in both the Senate and House, and supporters say the groundswell for expanded telehealth coverage and services could finally give the bill the momentum it needs for passage.

KEY TAKEAWAYS

The CONNECT for Health Act, first introduced in 2016, aims to expand oportunities and coverage for telehealth through Medicare.

This is the fifth time the bill has appeared before Congress, and telehealth advocates say the lessons learned from the pandemic and broad support for telehealth expansion could compel the bill across the finish line this time.

The bill would eliminate geographic restrictions and in-person exam requirements, expand who can use telehealth, and require more studies on telehealth’s value.

A bill that aims to improve and expand Medicare coverage for telehealth is back for a fifth time before Congress.

The CONNECT for Health Act of 2023, filed this week by US Senators Roger Wicker (R-Mississippi), Cindy Hyde-Smith (R-Mississippi), and Brian Schatz (D-Hawaii), continues a lengthy campaign by telehealth advocates to address the Centers for Medicare & Medicaid Services’ restrictive rules around who can use telehealth and what services are reimbursable.

A companion bill has been introduced in the House by US Reps. Mike Thompson (D-California), Doris Matsui (D-California), David Schweikert (R-Arizona), and Bill Johnson (R-Ohio).

As proposed this year, the bill would:

• Eliminate geographic restrictions on telehealth use and expand the list of allowed “originating sites” to include the home and other sites;
• Allow federally qualified health centers and rural health clinics to provide telehealth services;
• Expand the list of eligible healthcare providers to use telehealth;
• Eliminate the in-person visit requirement for telemental health services;
• Allow for a waiver of telehealth restrictions during future public health emergencies; and
• Mandate studies on how telehealth is used, how it impacts quality of care, and how it can be improved to support patients and providers.

The bill, first introduced in 2016, has a long list of supporters—some 60 senators are supporting this latest version—but has been unable to cross the finish line. Several provisions of previous versions of the CONNECT for Health Act were signed into law through separate bills or adopted by CMS, including actions to improve telemental health and telestroke care and integrate telehealth in home dialysis programs.

Supporters say the rapid and successful use of telehealth during the pandemic should give this bill a better chance of success.

“The pandemic showed us just how valuable telehealth is to ensuring folks receive care, but telehealth’s use goes far beyond navigating public health emergencies,” Hyde-Smith said in a press release announcing the bill’s reintroduction this week. “Mississippians and Americans face many obstacles accessing healthcare, whether it’s living in rural areas, old age, or mobility issues. This legislation would be key to providing them with the quality, affordable care they need and deserve. It’s time to get this done.”

“While telehealth use has skyrocketed these last few years, our laws have not kept up,” added Schatz, a well-known telehealth advocate. “Telehealth is helping people in every part of the country get the care they need, and it’s here to stay. Our comprehensive bill makes it easier for more people to see their doctors no matter where they live.”

Many of the flexibilities sought in this bill are in place through the end of 2024, thanks to an omnibus spending bill passed by Congress in December. Supporters say these provisions need to be made permanent to that healthcare organizations can map out long-term telehealth strategies and programs and consumers can access them without fear that they would be eliminated in a few years.

Among the many organizations supporting the bill is the American Telemedicine Association.

“Since originally introduced in 2016, the CONNECT for Health Act has envisioned a world where Medicare beneficiaries have access to virtual care services where and when they need them,” Kyle Zebley, the ATA’s senior vice president of public policy and executive director of ATA Action, said in a press release. “Today, our esteemed policy champions in Congress reintroduced an updated version of the CONNECT Act, including new and revised provisions that will help more people access telehealth services.”

“The pandemic showed us that we need to use technology to deliver care when and where it is needed,” added Rene Quashie, vice president of digital health for the Consumer Technology Association, the driving force behind the annual CES show in Las Vegas, in an e-mail to HealthLeaders. “Extending telehealth access for Medicare beneficiaries will help bridge gaps in distance, accessibility, and availability of crucial health services in communities across the nation. The CONNECT for Health Act is a step in the right direction to modernize our health care system, and CTA is proud to endorse it.”

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Despite numerous bills to solidify telehealth flexibilities enacted during the pandemic, none have passed in Congress, leaving the future of telehealth access and adoption uncertain.

By Anuja Vaidya

June 20, 2022 – The significant spike in the use of telehealth during the COVID-19 pandemic was made possible by numerous legislative waivers that were quickly enacted as in-person care stalled. Two years later, many of those flexibilities are still intact, but their future is unclear.

Three telehealth legislation experts — Jacob Harper, an associate with law firm Morgan, Lewis & Bockius, Christa Natoli, executive director of the Center for Telehealth and E-Health Law (CTeL), and Ben Steinhafel, policy director of CTeL — discussed the current regulatory landscape for telehealth at the federal and state levels on the Healthcare Strategies podcast.

At the federal level, several bills have been introduced to make permanent or extend flexibilities enacted during the pandemic, including the CONNECT for Health Act and Telehealth Extension Act. One of the key provisions in these bills is eliminating geographic restrictions on originating sites for telehealth services.

But none of these bills have passed yet, though Congress did extend telehealth waivers for Medicare beneficiaries for at least five months after the public health emergency officially expires.

“I think one of the things that’s been interesting to me is some of these bills have been sitting in Congress since the middle of 2020,” Harper said. “These bills already [have] a majority of the senators not just supporting but co-sponsoring the bills.”

Cost may be one of the factors blocking the passage of these bills. Lawmakers are still debating whether the costs associated with virtual care are additive, meaning that they increase the overall cost of care, or substitutive, which means they lower costs or keep them steady.

“That’s really the big thing…that’s holding Congress back from just saying, ‘Okay, let’s just run with these,'” Harper said. “Because I think there’s definitely a lot of bipartisan support.”

To buy more time to examine costs and other potential impacts of permanent telehealth expansion, Natoli believes that Congress may choose to extend the flexibilities for two years initially.

“It’s likely that they will probably move forward with some temporary solution, like a two-year extension,” she said. “They could have time to analyze some cost drivers as it applies to eliminating these originating site restrictions.”

At the state level, licensure hurdles are creating access barriers to telehealth, according to Steinhafel.

“That’s a big challenge for a lot of telemedicine platforms and vendor service providers that are trying to operate in several states — just being able to navigate that licensure process looks different in every state,” he said.

As public health emergency orders expire state by state, providers may need to undergo lengthy licensure procedures to continue providing virtual care to patients across state lines.

“I’m not sure that there’s a great federal solution for that, but it does take coordination among a lot of states,” Harper said.

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COVID-19 has led to dramatic increases in adoption of telehealth by both physicians and patients. Policymakers should seize the opportunity to make permanent policy that supports many of these advancements beyond the pandemic.

Why telehealth is important

In the March 15, 2022, episode of Moving Medicine, AMA Chief Experience Officer Todd Unger discusses the importance of protecting the future of telehealth with Jason Marino, AMA director of Congressional Affairs.

Early on in the COVID-19 pandemic, with strong support of the AMA, the restrictions on coverage for telehealth services were lifted by Medicare and other health plans.

Unfortunately, many of the telehealth flexibilities that have greatly improved patient access to care throughout the pandemic are set to expire five months after the end of the national public health emergency. In a survey (PDF) conducted by the AMA on telehealth usage, nearly 70% of physician respondents reported an interest in continuing to provide telehealth services. However, much of this continued use and expansion of services will not be possible with a return to the previous lack of insurance coverage and payer reimbursement.

Achieving permanent Medicare coverage of telehealth services for patients, including allowing them to continue receiving these services in their homes, is important for patient access to care. The AMA is working to ensure (PDF) physicians have the tools, resources and support to seamlessly integrate telehealth into their practices without financial risk or penalty.

Federal work on telehealth policy

Prior to March 2020, the Medicare program only paid for telehealth services in very limited circumstances:

• Patients had to reside in rural areas
• Patients could only receive telehealth services at a medical facility
• Two-way audio-video telecommunications equipment had to be used
• A limited number of services were on the Medicare Telehealth List
• Because payments were at facility rates, they were about 30% below in-office payment rates

During the nationwide COVID-19 Public Health Emergency (PHE), the AMA successfully advocated for Medicare to pay for telehealth:

• In rural and non-rural areas all over the country
• To patients in their homes or wherever they are located without the need to go to a medical facility
• From physicians providing telehealth services from home or wherever they are located
• Using audio-video telecommunications equipment, smartphones or audio-only telephones including landlines
• At the same rates as in-person physician office services
• For a greatly expanded number of codes, including telephone visits, emergency department visits, home visits, hospital-at-home services and many types of therapy

The AMA also strongly supports a law enacted in March 2022 that will extend many of the telehealth policies that were put in place for the PHE for an additional five months after the PHE ends.

The biggest challenge now is to get legislation enacted that will permanently lift the rural-only and originating site restrictions (PDF) on telehealth coverage for Medicare patients.

• The Telehealth Modernization Act of 2021 would lift the rural-only restriction and add any site where a patient is located as a potential originating site.
• The CONNECT for Health Act would lift the rural-only restriction, add the home as an originating site, establish a process for the Secretary of the U.S. Department of Health and Human Services (HHS) to add originating sites and provide HHS with the permanent authority to waive section 1834(m) restrictions.
• The Telemental Health Care Access Act is a bipartisan bill that would repeal a new requirement that a patient must see a provider in person within six months of receiving a mental health telehealth service.

State work on telehealth policy

The AMA provides state-level policy guidance and recommendations to expand coverage, access and payment of telehealth services.

On the state level, the AMA has been working to:

• Support coverage and payment of telehealth
• Require insurers to allow all contracted physicians to provide care via telehealth
• Support hybrid models of care where physicians utilize both telehealth and in-person care
• Eliminate separate telehealth networks as well as policies that steer patients to select telehealth providers instead of their regular physicians
• Prevent plans from using telehealth to meet network adequacy requirements

Additionally, the AMA supported the adoption of “The Appropriate Use of Telemedicine Technologies in the Practice of Medicine” by the Federation of State Medical Boards as an update to their 2014 guidelines. The new document provides guidance to state medical boards on the use of telemedicine in the health care setting and can serve as a model policy for the permanent adoption of telemedicine at the state level.

Equity in telehealth

The AMA has created an issue brief (PDF) outlining specific policy proposals to take significant and necessary steps toward promoting and ensuring equity in telehealth.

State and federal correspondence

• Comment letter (PDF) to the Federation of State Medical Boards supporting their updated Telemedicine Policy.
• Sign-on letter (PDF) successfully urging congressional leaders to extend telehealth flexibilities for five months after the end of the national public health emergency.
• Statement for the record (PDF) to the U.S. House of Representatives Ways and Means Subcommittee on Health supporting continued access to telehealth services for Medicare beneficiaries.

Webinar on telehealth policy

AMA Advocacy Insights webinar series: The future of telemedicine

To address the dramatic increase in telemedicine use as a result of the COVID-19 pandemic, the Federation of State Medical Boards (FSMB) House of Delegates recently updated and adopted “The Appropriate Use of Telemedicine Technologies in the Practice of Medicine.” During this AMA Advocacy Insights webinar, experts from the FSMB provide an overview of the updated policy, discuss current state licensure laws regarding telemedicine and outline continued solutions that can be implemented moving forward.

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A bipartisan group of 45 elected officials asked congressional leadership to include a short-term extension of Medicare services in government funding legislation.

By Kat Jercich January 31, 2022 02:54 PM

Dozens of U.S. senators and representatives urged congressional leadership this past Friday to safeguard Medicare telehealth services.  

Led by Sens. Brian Schatz, D-Hawaii, and Roger Wicker, R-Miss., the bipartisan group of 45 elected officials published a letter calling for Senate Majority Leader Chuck Schumer, Senate Minority Leader Mitch McConnell, House Speaker Nancy Pelosi and House Minority Leader Kevin McCarthy to extend expanded coverage of Medicare telehealth services for a set period of time, via February government funding legislation.  

“Telehealth has been a critical tool during the COVID-19 pandemic to ensure that patients continue to receive the health care they need while keeping health care providers and patients safe,” read the letter.  

WHY IT MATTERS

As the officials noted, the current telehealth flexibilities are tied to the public health emergency, which is renewed in three-month increments.   

Although legislators have made efforts to pass more permanent telehealth laws, none have yet made significant traction.

So, in the interim, a short-term extension of the kind that letter signers are requesting would provide what they called “much-needed certainty” to healthcare providers and patients.  

“Without more definitive knowledge about the duration of the pandemic and Medicare’s long-term coverage of telehealth, many organizations have been hesitant to fully invest in telehealth,” the letter read.  

“An extension of the telehealth authorities would provide assurance that the investments will be sustainable over the long term. It would also reassure patients that their care will not end abruptly,” it continued.  

Legislators also pointed to the chance to collect more data on the uses and impacts of virtual care.  

“This data could help inform Congress’ next steps on permanent telehealth legislation and appropriate program integrity and beneficiary protections,” the elected officials wrote.  

“In the meantime, it is crucial that an extension not include unnecessary statutory barriers in accessing telehealth services during this data collection and analysis period,” they added.  

THE LARGER TREND  

Members of Congress have put forth several efforts toward making various COVID-19-era telehealth flexibilities permanent, including the CONNECT for Health Act and the Telehealth Modernization Act.

Meanwhile, members of the healthcare industry and advocates have ramped up their own pressure, launching a new affiliated trade organization this past week aimed at supporting the enactment of state and federal telehealth coverage throughout the country.  

ON THE RECORD  

“Telehealth has become an essential part of the healthcare system,” read the letter. “In February, Congress should extend the authorities that have expanded coverage of telehealth services during the COVID-19 pandemic in order to maintain access to telehealth and provide necessary certainty for Medicare telehealth coverage.”

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