Legislation Archives · mTelehealth

Telehealth, hospital-at-home extensions pass key House committee

Dr. M Telehealth — Thu, 19 Sep 2024 17:13:38 +0000

Bills that would extend expiring telehealth and hospital-at-home authorities and reverse a regulation establishing staffing mandates for nursing homes are ready for final votes in the House after committee consideration Wednesday.

The Energy and Commerce Committee met to vote on a number of healthcare bills at the session. Among them was the Telehealth Modernization Act of 2024, which passed unanimously.

The legislation would permit broader use of telehealth under Medicare for two more years and retain the Medicare hospital-at-home program for five more years. Both policies, due to run out Dec. 31, originated during the COVID-19 pandemic and providers have clamored for them to be reauthorized.

“We can all agree that one of the silver linings of the pandemic was unlocking the incredible potential of telehealth,” said Rep. Doris Matsui (Calif.), ranking Democrat on the panel’s Communications and Technology Subcommittee. “We need to ensure seniors can get the care they need when they need it. And I look forward to a future where we can recognize telehealth as a crucial piece of our healthcare system, rather than a temporary fix we must extend every two years.”

The legislation targets pharmacy benefit managers to finance these extensions via projected savings on Medicare prescription drug costs.

PBMs would be barred from linking compensation to drug list prices, be required to charge flat fees for negotiating prices, and have to provide extensive data to plan sponsors and federal regulators. PBMs have adamantly opposed such measures, arguing they would enrich pharmaceutical manufacturers.

The Energy and Commerce Committee also voted 21-18 along party lines to repeal the Centers for Medicare and Medicaid Services final rule that establishes minimum nurse staffing standards for nursing homes. Under that regulation, skilled nursing facilities must provide at least 3.48 hours of nursing care per resident, per day, including at least .55 hours from a registered nurse.

The mandate triggered vehement opposition from the American Health Care Association and other nursing home industry groups and met resistance on Capitol Hill, mostly from Republicans.

The skilled nursing facility industry and sympathetic lawmakers argue the requirements are too costly and will force nursing homes to close. According to the health policy research institution KFF, only about one in five nursing homes currently meets those benchmarks.

“The Biden administration is proposing an unfunded mandate that will decrease access to nursing homes for some of our most vulnerable patients living in my district and across the country,” said Rep. Buddy Carter (R-Ga.). “Nursing homes are not suffering from a lack of mandates. They’re facing a lack of nurses. This rule would only make things worse for our seniors and the healthcare providers who support them.”

Democrats have defended the rule, siding with nurses’ unions and patient advocates who maintain that minimum staffing levels are necessary to keep patients safe and allow nurses to do a good job.

“The evidence shows that, on average, more staffing helps, and it helps a lot,” said Rep. Diana DeGette (D-Colo.). “Mandating staffing is a the most serious idea anyone has come up with so far for improving nursing homes. We’re certainly not considering anything today that will address the crisis facing seniors.”

The fates of both measures is uncertain. Congress is approaching its pre-election recess in less than two weeks and is scrambling to advance legislation to keep the federal government open and sustain various programs past the end of the fiscal year on Sept. 30.

The telehealth bill has strong support in the GOP-led House and the majority-Democrat Senate. Whether it passes will depend on how Congress proceeds with funding bills and a collection of other healthcare measures. Lawmakers have been trying since last year to craft a broad healthcare package that could either move on its own or be added to a bigger spending measure.

The nursing home staffing mandate repeal is likely to pass the House if leaders bring it to the floor. The bill’s prospects in the Senate are less clear.

The staffing rule legislation is advancing under what’s known as the Congressional Review Act, which allows the legislative branch to invalidate new regulations within specific timeframes and provides expedited Senate procedures that allow passage on simply majority votes that aren’t subject to filibusters.

Democrats have a slim 51-49 Senate majority, including four independents who caucus with them. The staffing mandate bill could move forward if enough Democrats and allied independents join Republicans to scrap a major initiative from President Joe Biden. Sens. Jon Tester (D-Mont.) and Joe Manchin (I-W. Va.) have already joined Republicans who support repealing the rule.

But Biden almost certainly would veto a standalone measure to undo his signature nursing home policy.

Federal government funding runs out in 12 days, and advancing a spending bill has gotten enmeshed in 2024 election politics, complicating passage and efforts to attach healthcare measures to an appropriations bill.

A more likely scenario is that lawmakers find a way to pass the more popular and bipartisan measures after Election Day in a lame duck session, perhaps as part of a full-year spending bill.

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Hospital-at-home, telehealth extension advances in Congress

Dr. M Telehealth — Thu, 19 Sep 2024 17:08:51 +0000

A U.S. House committee unanimously passed a bill Sept. 18 that would extend the hospital-at-home program and telehealth flexibilities.

The Telehealth Modernization Act of 2024 moved out of the Committee on Energy and Commerce and will now go before the full House. The legislation, which would be funded by pharmacy benefit manager reform, would continue the CMS hospital-at-home waiver for five years and ease telehealth rules on Medicare recipients for two years.

“Seniors, individuals with mobility issues, and those living in rural areas rely on telehealth to bring qualified healthcare professionals right to their home,” said bill sponsor Rep. Earl “Buddy” Carter, R-Ga., in a Sept. 18 statement. “I urge a swift House floor vote on this bill so that we can get Medicare beneficiaries the life-saving health care they need.”

Without an extension, the COVID-era flexibilities will expire at the end of 2024. CMS has approved 345 hospitals across 137 health systems to provide acute hospital care at home since the waiver started in 2020.

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CMS proposes new payments for digital health under CY2025 PFS draft rule

Dr. M Telehealth — Mon, 05 Aug 2024 15:22:29 +0000

The Centers for Medicare & Medicaid Services’ (CMS’) proposed calendar year 2025 physician fee schedule rule, out Wednesday, proposed an assortment of new payments and coverage for digital health services, including digital therapeutics, telehealth and audio-only telehealth services. It did not, however, address the bulk of Medicare telehealth waivers expiring at the end of the year, which need to be extended by Congress.

The draft rule contains significant proposals for rural health clinics and federally qualified health centers to continue receiving payment for audio-only telehealth, waive the in-person visit requirement for telemental health services and report remote monitoring codes outside of catch-all code G0511.

CMS’ proposal also gives opioid treatment programs more flexibility in their use of telehealth and audio-only telehealth services, which the agency says will improve health equity.

Digital therapeutics

CMS provided a lengthy section on digital therapeutics used in the course of behavioral health care treatment. The section proposes to create three new codes for digital mental health treatment devices like digital therapeutics, though it’s unclear whether the new codes would substantially change the status quo.

CMS proposes in its CY2025 physician fee schedule draft rule that three new codes, GBMT1-3, pay for the supply of a digital mental health treatment device and for physician time spent interacting with the patient regarding the device. The proposal would allow providers to receive reimbursement for the use of FDA-cleared devices that leverage software to provide behavioral health therapies.

CMS says the new codes are direct crosswalks of existing remote therapeutic monitoring codes 98980 and 98981 and that they refine the language of its 2021 cognitive behavioral therapy code, all of which have allowed for some payment for digital therapeutics over the last several years.

A payment and coding expert told Fierce Healthcare that the new codes don’t seem to substantially differ from existing RTM and CBT codes.

The PFS notes that other digital therapeutics require the creation of a new Medicare benefit category and are not covered under the proposal. It also said that digital mental and behavioral health apps and interventions cannot use this code.

Telehealth

CMS proposed some extensions of pandemic-era telehealth provisions and even proposed to make a few telehealth line items permanent in its calendar year 2025 physician fee schedule draft rule.

Congress must extend or make permanent the majority of Medicare telehealth waivers through legislation, which is likely to happen in the lame duck session. Because CMS does not have the authority to extend the bulk of Medicare telehealth waivers, the proposed CY2025 draft rule omits the core waivers that enabled telehealth flexibilities, such as allowing telehealth visits to be conducted from anywhere, allowing an expanded set of providers to bill for telehealth, waiving the need for an in-person visit for telemental health and allowing hospitals to launch acute hospital care-at-home programs.

CMS proposed to permanently allow virtual direct supervision for some services with established patients and extended virtual direct supervision for all services through the end of CY2025. It also extended through the end of 2025 the ability for a teaching physician to be present for critical parts of the visit via a three-way telehealth visit for billing purposes.

CMS declined to include the 17 new telehealth evaluation and management (E&M) codes, which the agency said were duplicative of existing E&M codes used for in-person visits. The Alliance for Connected Care has advocated that CMS reject the telehealth codes and instead use a modifier on existing in-person codes to signify the use of telehealth.

CMS proposed to delay the requirement that telehealth providers report their home address on publicly available Medicare documentation through the end of CY2025.

The American Telemedicine Association (ATA) told Fierce Healthcare that the telehealth wins in the fee schedule proposed rule would be significantly impacted if Congress does not act to continue waiving geographic and originating site restrictions.

“That’s the difference between under 1% of Medicare beneficiaries having access to telehealth services, which would be the case if you were to re-implement those geographic and originating site restrictions … you’re cutting out urban and suburban America in one fell swoop,” Kyle Zebley, senior vice president of the ATA, said.

Rural health clinics and federally qualified health centers

CMS proposes to allow rural health clinics (RHCs) and federally qualified health centers (FQHCs) to use audio-only for telehealth visits. It also proposes RHCs/FQHCs be able to waive the required in-person visit for the provision of telemental health through the end of 2025.

CMS proposes to split catch-all code G0511 into distinct payments based on the service rendered. G0511 has been used as an add-on code for care coordination and management services like chronic care management, remote monitoring and nearly 20 other related codes.

CMS clarified in the CY2024 PFS rule that G0511 could be billed as many times as needed to get proper payment for the services, but rural health payment experts still were skeptical of how and if Medicare administrative contractors would pay the multiple G0511 claims out.

Remote monitoring

CMS proposed to cut reimbursement for remote therapeutic monitoring, continuing a multiyear trend. Otherwise, remote monitoring did not receive significant attention in the draft physician pay rule. CMS did not address concerns digital health stakeholders have over the 16-day data reporting requirement to bill RPM and RTM codes or any of the other myriad billing restrictions for the codes.

CMS discussed remote monitoring in its proposed Advanced Primary Care Model. As proposed, the model would encourage billing of remote monitoring on top of the monthly advanced primary care payment.

Opioid treatment programs

CMS proposes to make significant changes to opioid treatment programs’ ability to use telehealth and audio-only visits. The agency proposes allowing audio-only assessments permanently starting in CY2025 along with audio-visual assessments.

The agency also proposes to permanently allow audio-visual and audio-only telehealth visits to be used to induct patients into buprenorphine treatment at opioid treatment programs. The agency is also proposing to allow audio-visual telehealth visits used to induct patients into methadone treatment, in accordance with a Substance Abuse and Mental Health Services Administration final rule published in February.

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Senate Subcommittee Examines Making Medicare Telehealth Coverage Permanent

Dr. M. Rosen — Tue, 14 Nov 2023 14:25:56 +0000

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-Supported Bill Would Expand Access to Telehealth Services

Dr. M. Rosen — Tue, 10 Oct 2023 14:50:17 +0000

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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Acute Inpatient PPS

Dr. M. Rosen — Wed, 06 Sep 2023 15:44:09 +0000

Learn What’s New for FY 2024

CMS issued FY 2024 Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital Prospective Payment System (LTCH PPS) final rules to update IPPS hospital and LTCH Medicare payment policies. See a summary of key provisions effective October 1, 2023.

On January 30, 2023, the Biden Administration announced its intent to end the national emergency and public health emergency declarations on May 11, 2023, related to the COVID-19 pandemic. Section 3710 of the CARES Act directs the Secretary to increase the weighting factor of the assigned Diagnosis-Related Group (DRG) by 20 percent for an individual diagnosed with COVID-19 discharged during the COVID-19 Public Health Emergency (PHE) period. Therefore, this 20 percent increase would not be applicable for IPPS discharges occurring on or after May 12, 2023.

Section 1886(d) of the Social Security Act (the Act) sets forth a system of payment for the operating costs of acute care hospital inpatient stays under Medicare Part A (Hospital Insurance) based on prospectively set rates. This payment system is referred to as the inpatient prospective payment system (IPPS). Under the IPPS, each case is categorized into a diagnosis-related group (DRG). Each DRG has a payment weight assigned to it, based on the average resources used to treat Medicare patients in that DRG.

The base payment rate is divided into a labor-related and nonlabor share. The labor-related share is adjusted by the wage index applicable to the area where the hospital is located, and if the hospital is located in Alaska or Hawaii, the nonlabor share is adjusted by a cost of living adjustment factor. This base payment rate is multiplied by the DRG relative weight.

If the hospital treats a high-percentage of low-income patients, it receives a percentage add-on payment applied to the DRG-adjusted base payment rate. This add-on, known as the disproportionate share hospital (DSH) adjustment, provides for a percentage increase in Medicare payment for hospitals that qualify under either of two statutory formulas designed to identify hospitals that serve a disproportionate share of low-income patients. For qualifying hospitals, the amount of this adjustment may vary based on the outcome of the statutory calculation.

Also, if the hospital is an approved teaching hospital it receives a percentage add-on payment for each case paid through IPPS. This add-on known as the indirect medical education (IME) adjustment, varies depending on the ratio of residents-to-beds under the IPPS for operating costs, and according to the ratio of residents-to-average daily census under the IPPS for capital costs.

Finally, for particular cases that are unusually costly, known as outlier cases, the IPPS payment is increased. This additional payment is designed to protect the hospital from large financial losses due to unusually expensive cases. Any outlier payment due is added to the DRG-adjusted base payment rate, plus any DSH or IME adjustments.

Transition of Inpatient Hospital Review Workload

Please see links below in the Downloads Section to some helpful informational materials on the subject of Inpatient Prospective Payment System Hospital and Long Term Care Hospital Review and Measurement.

Hospital Center

For a one-stop resource web page focused on the informational needs and interests of Medicare Fee-for-Service (FFS) hospitals, go to the Hospital Center (see under “Related Links Inside CMS” below).

Downloads

Congress Lines Up to Support Permanent Changes to Telehealth Rules

Dr. M. Rosen — Mon, 26 Jun 2023 18:55:17 +0000

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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Telehealth groups applaud CONNECT reintroduction in Senate

Dr. M. Rosen — Thu, 22 Jun 2023 15:34:58 +0000

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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Near supermajority in Senate backs telehealth’s future

Dr. M. Rosen — Wed, 21 Jun 2023 13:50:24 +0000

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.

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.

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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US Senators Support Permanent Telehealth Access Through Legislation

Dr. M. Rosen — Fri, 16 Jun 2023 13:45:59 +0000

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

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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