Tuesday, April 27th, 2021
WASHINGTON, D.C. (April 27, 2021)—A bipartisan group of U.S. senators introduced legislation on Thursday, April 22, to provide reimbursement to providers for telehealth services in the Medicare Home Health benefit.
Introduced as S. 1309, the Home Health Emergency Access to Telehealth (HEAT) Act is a top 2021 legislative priority for the National Association for Home Care & Hospice (NAHC).
While the concept of allowance for reimbursement for telehealth services is not a new one, the prohibition has become a glaring shortcoming in the era of the coronavirus pandemic. In the early days of the pandemic, NAHC advocated relentlessly for this telehealth expansion. Congress ultimately elected to provide encouragement to the Centers for Medicare & Medicaid Services (CMS) on incorporating telehealth into the home health benefit as opposed to a firm directive.
The new legislation calls for permitting CMS the authority to issue a waiver that would allow for telehealth visits to count towards in-person visits as included on the plan of care in the event of a public health emergency (PHE). During the drafting, concerns were raised of the need for patient protections to ensure for protection against fraudulent and improper behavior. To assuage these concerns, guardrails were added that would require for patient consent for telehealth services, as well as a requirement that telehealth visits can comprise of no more than half of all visits. The bill will also require a pre-existing relationship between the patient and ordering physician for the patient to be eligible to receive reimbursable telehealth services.
“The COVID-19 pandemic has firmly demonstrated the value of telehealth as to tool in meeting the clinical needs of home health patients,” said NAHC President Bill Dombi. “However, with the absence of any reimbursement for teleheath, home health agencies have not had the ability to make full use of it. The HEAT Act is a big step forward in modernizing the Medicare home health benefit. We thank the Senators for their bipartisan sponsorship of the bill and look forward to an early passage.”
This HEAT Act is a reintroduction of the same legislation from the previous Congress. Longtime home health champions Sens. Susan Collins (R-Maine) and Ben Cardin (D-Maryland) teamed up to lead the original version introduced in 2020. For the 117th Congress Sens. Collins and Cardin are joined in introduction by Sens. Roger Marshall (R-Kansas) and Jeanne Shaheen (D-New Hampshire). In the last Congress, then Rep. and now Sen. Marshall, served as the lead sponsor on the House version of the HEAT Act.
With the HEAT Act officially introduced in the Senate, NAHC will be actively working to build additional Senate support and to win introduction of a companion bill in the House of Representatives.