Last week S. 2741 (Sen. Schatz) and HR 4932 (Rep. Thompson), the Creating Opportunities Now
for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019
(CONNECT Act), were introduced in order to amend the Social
Security Act to expand access to telehealth in the Medicare program.
Medicare currently only reimburses for live-video telehealth services,
and asynchronous services (store-and-forward) is not permitted for
reimbursement (except for Federal telemedicine demonstration programs in Alaska
or Hawaii). Additionally, current law places specific restrictions on the
originating site (i.e. the physical location of the patient), practitioner at
the distant site (i.e. the physical location of the practitioner) and types of
services that can be delivered. One of the most significant restrictions
is requiring the patient to be located in a rural area, although there are some
exceptions for specific circumstances.
The CONNECT Act would address these barriers to telehealth access by allowing the Secretary to waive any of the current restrictions (geographic, originating site, modality limitation, provider type and service requirements) applicable to telehealth if the waiver would not deny or limit the coverage or provision of benefits and the Secretary determines that:
The Secretary would be
required to establish a process for stakeholders to submit comments on the
waivers and on a biennial basis post on the CMS website specific information
pertaining to the waiver.
CONNECT Act also would create an exception for mental health services from the
geographic requirement and allow the home to serve as an originating site.
Other circumstances that would warrant an exception from the geographic
requirement would include emergency medical care (when furnished in a critical
access hospital, hospital or skilled nursing facility), services in federally
qualified health centers (FQHCs), rural health clinics (RHCs), and Native American
health service facilities and national emergencies. FQHCs and RHCs would
also be allowed to serve as distant site providers under the Act. The
CONNECT Act also addresses alternative payment models and the process by which
CMS approves new codes for telehealth reimbursement. For more information, see
the full text of the bill and
reference CCHP’s factsheet and comparison chart outlining
the different elements of the bill.
Also in October, Representative Harder announced through a press release plans for the Specialty Treatment Access and Referral (STAR) Act, which would create a grant program to help health care organizations establish information-sharing and connectivity infrastructure to provide eConsults and other telehealth services. Stay tuned for more information once the bill is formally introduced.