Relief bill provisions complicate care for homebound patients

The $900 billion COVID-19 relief bill signed into law by President Trump Dec. 27 offers Medicare coverage for telemental health and rural hospitals and funding for broadband connectivity, but criticism of the bill remains. The reason: the bill doesn’t extend the emergency telehealth access and the coverage provisions offered early on during the pandemic.

Lobbying to make at least some of those provisions permanent were the American Telemedicine Association, Alliance for Connected Care and Connected Health Initiative, some healthcare providers and dozens of lawmakers.

“The noticeable lack of permanent reform or a guaranteed extension of the telehealth flexibilities in this relief package is disheartening for the millions of Americans who relied on telehealth to access care,” and our healthcare providers still on the frontlines of the pandemic,” ATA CEO Ann Mond Johnson said in a press release issued after Congress passed the bill. “We believe arbitrary restrictions on telehealth must be permanently removed to make way for a modernized and more accessible healthcare system.”

For telemental health, the bill requires patients and providers to meet in person within six months of an initial telehealth session and then meet in person for exams at regular intervals, complicating care for those at home.

“We are disappointed that the telemental health provision includes an in-person requirement, as we strongly believe a provider-patient relationship can be established via telehealth,” Johnson said. “Particularly in light of the crippling provider shortage, this in-person pre-existing relationship requirement will unnecessarily deprive Medicare beneficiaries of telemental health options, and we are hopeful Congress will remove this provision in the near future.”

In a separate news release, the Alliance for Connected Care said that “[a]dding an in-person requirement prevents people that are homebound, transient, or have existing healthcare access challenges from using telehealth – really negating so much of the value that telehealth creates in helping people that NEED expanded access to care.”