Medical associations, health systems, vendors and other stakeholders are asking Senate and House leaders to prioritize four areas when enshrining permanent changes to telemedicine regs.

By Kat JercichJune 30, 2020

Three hundred and forty healthcare organizations published an open letter Monday asking Senate and House leaders to permanently enshrine changes to policies that would make telehealth accessible in the long term.

The groups, which included Healthcare IT News parent company HIMSS and 17 regional HIMSS chapters, the American Telemedicine Association, the American Association of Nurse Practitioners, the American Heart Association, the Rural Hospital Coalition, the California Association of Public Hospitals and Health Systems, and the ERISA Industry Committee, among a wide range of stakeholders, noted that the coronavirus pandemic has triggered an unprecedented wave of interest and participation in telemedicine among doctors and patients. 

“Much of this transformation is dependent on temporary flexibilities extended to health systems and providers that are limited to the duration of the COVID-19 public health emergency declaration,” the letter read.

Signers pointed out that the authorities granted to the Department of Health and Human Services and the Centers for Medicare and Medicaid Services are restricted to the public health emergency period triggered by COVID-19.

“Congress must act to ensure that the Secretary has the appropriate flexibility to assess, transition, and codify any of the recent COVID-19-related telehealth flexibilities and ensure telehealth is regulated the same as in-person services,” they continued. 


“Swift congressional action will provide a clear signal to patients, who are concerned about the future of their telehealth benefits, as well as providers and health systems, which are hesitant to make investments in critical healthcare infrastructure without certainty from policymakers,” said the industry stakeholders.

Letter signers – whose organizations represented all 50 states, the District of Columbia and Puerto Rico – asked Congress to prioritize four main areas when pushing forward permanent changes to telemedicine.

First, Congress should permanently remove geographic originating site requirements to allow reimbursement regardless of where a patient is located, including in their own home.

Second, lawmakers should provide the HHS Secretary with the flexibility to expand the list of eligible telehealth providers and services.

“Similarly, HHS and CMS should maintain the authority to add or remove eligible telehealth services – as supported by data and demonstrated to be safe, effective, and clinically appropriate – through a predictable regulatory process that gives patients and providers transparency and clarity,” according to the letter.

Stakeholders also called on lawmakers to ensure federally qualified health centers and rural health centers can continue to provide telehealth care – though they did not specify how Congress should do so – and to make HHS’s temporary waiver authority permanent during emergencies in the case of future crises.

“These priorities ensure HHS and CMS have the necessary authority to maintain oversight of telehealth services, guaranteeing access to safe, effective, and appropriate care while targeting clearly outdated statutory restrictions that discriminate based on geography and patient location,” they wrote.


A number of lawmakers on both sides of the aisle have already signaled their willingness to support some of the requests outlined by the industry groups.

Senate HELP Committee Chair Sen. Lamar Alexander, R-Tenn., said last week that he was in favor of the originating site rule-change and the expansion of Medicare- and Medicaid-reimbursable services. 

Meanwhile, U.S. Reps. G.K. Butterfield, D-N.C., and Glenn Thompson, R-Pa., introduced legislation earlier this month to codify Medicare reimbursement of virtual care at FQHCs and RHCs.

Other lawmakers, including Sen. Tina Smith, D-Minn., have pushed forward bills that would evaluate telehealth programs nationwide in order to help determine how much change the federal government can make in terms of protecting access without needing additional legislative authority.


“As we all work to understand the impact of the waivers put in place in response to the pandemic and assess what should be made permanent, we encourage Congressional leaders to focus on existing statutory barriers that must be immediately addressed to ensure the administration can appropriately transition and modernize telehealth under Medicare and importantly, keep us all from falling off the ‘telehealth cliff,'” said ATA president Ann Mond Johnson in a statement accompanying the letter.

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