‘I can’t imagine going back’: Medicare leader calls for expanded telehealth access after Covid-19

President Trump’s top Medicare official said Tuesday that expanded access to telemedicine should continue after the coronavirus pandemic recedes and that officials are examining ways to act without waiting for legislation from Congress.

“I can’t imagine going back,” said Seema Verma, administrator of the Centers for Medicare and Medicaid Services, told STAT during a live virtual event. “People recognize the value of this, so it seems like it would not be a good thing to force our beneficiaries to go back to in-person visits.”

The comments were Verma’s most forcible remarks to date on the need to preserve access to telemedicine following the outbreak. During the past three months, virtual visits have increased more than 40-fold in some parts of the country.

However, in a possible headwind for telemedicine, Verma said the government must evaluate whether it should continue paying the same for virtual visits as for in-person care. Equalizing payment during the pandemic was one of the driving forces behind the telemedicine expansion.Volume 90% 

“Right now for the public health emergency we’re maintaining that equilibrium, but going forward that’s something that needs to be looked at,” Verma said. “I don’t see it as a one-to-one. …I think there are some potential savings for the system that do occur by having a telehealth visit.”

But Verma was adamant in an interview that the increase in telemedicine visits has significantly improved access to care. She said weekly telemedicine visits jumped to more than 1 million a week, compared to about 12,000 before coronavirus began to spread in the U.S. in March.

Verma said action from Congress will ultimately be needed to permanently expand telemedicine on a national basis, as existing laws limit coverage to people living in rural areas where access to care is particularly strained. But she said CMS is evaluating ways to preserve access to telemedicine visits in settings such as patient’s homes, hospice care, and nursing homes. It is also considering ways to permanently broaden the types of services that can be provided via telemedicine, such as emergency care, physical therapy, and mental health consultations.

Verma added that the administration would support efforts to allow more telemedicine to be practiced across state lines. Currently, doctors are limited to providing care in the states where they have licenses, which in many cases prevents patients from accessing care delivered by doctors who live across state lines. CMS has relaxed those regulations for the duration of the pandemic.

“For us to truly leverage the potential in the power of telehealth, we’re going to have to rethink our laws around licensing,” Verma said. “Is it really necessary to have those borders? We should allow…practicing across state lines, because it really has the potential to provide better services and reduce some of those shortages, especially in some of the highly specialized fields.”