Pressure mounts on Congress to enact telehealth reform

Pressure is ratcheting up on Congress to extend, and possibly make permanent, the eased access to telehealth for Medicare beneficiaries that has been in effect since the start of the COVID-19 pandemic.

On January 28, 45 members of Congress from both parties wrote to the leaders of the U.S. Senate and House of Representatives urging them to introduce legislation to permanently expand Medicare coverage for telehealth and eliminate other barriers to its use, citing telehealth’s ability to “expand access to care, reduce costs, and improve health outcomes.”

While such legislation is being developed, the letter adds, an extension of the pandemic telehealth authorities should be included as part of government funding legislation Congress will vote on later this month. The writers note that currently such authorities are temporary and tied to the pandemic public health emergency (PHE) declaration, which is only renewed in three-month increments.

“Without more definitive knowledge about…Medicare’s long-term coverage of telehealth, many organizations have been reluctant to fully invest in telehealth,” the letter says. Extending the telehealth authorities would help assure health care organizations that their investments will be sustainable and would reassure patients that their care will continue.

A second letter to Congressional leadership, sent January 31, also supports making permanent much of the increased flexibility around Medicare telehealth coverage in place since the start of the COVID-19 pandemic. It has 336 signatories, including the American Telehealth Association, the Alliance of Community Health Plans, the American Medical Association and numerous other health care and nonprofit organizations.

Noting the uncertainty created by the need to continually renew the PHE, the letter asks for “permanent telehealth reform that would provide certainty to beneficiaries and health care providers while providing sufficient time for Congress and the Administration to analyze the impact of telehealth on patient care.”

To achieve those goals, the letter requests Congress to:

• Authorize continuation of all current telehealth waivers through the end of 2024. Doing so, it says, would give HHS the authority and flexibility to remove reimbursement restrictions such as those on geographic and originating sites and in-person requirements for telemental health consultations
• Require HHS to complete all feasible evaluations related to telehealth by fall 2023 and combine its findings into a single overarching dashboard with recommendations for permanent telehealth legislation
• Consider permanent, evidence-based telehealth legislation for implementation in 2024. The evaluations it recommends be carried out in 2022-2023 would provide all committees with jurisdiction “the necessary data to pursue evidence-based policymaking and take up permanent telehealth reform in a bipartisan manner.”

“In the 21st century, all patients should have the option to receive care virtually when clinically appropriate—Congress should not restrict CMS or other payers from covering appropriate modalities of care,” the letter says.