Senate Bill Would Extend Telehealth Flexibilities Beyond Pandemic

A bipartisan group of U.S. Senators have reintroduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021. If enacted the bill would expand Medicare coverage of telehealth service and make permanent flexibilities for virtual services implemented on a temporary basis during the COVID-19 pandemic.

Primary sponsors include Sens Brian Schatz (D-HI), Roger Wicker (R-Miss.), Ben Cardin (D-Md.), John Thune (R-S.D.), Mark Warner (D-Va.) and Cindy Hyde-Smith (R-Miss.), along with 50 co-sponsors. A similar bill has been proposed in the U.S. House of Representatives.

“The last year has shown us that telehealth works, it’s popular, and it’s here to stay,” said Schatz. “Our comprehensive bill makes it easier for more people to safely get the care they need no matter where they live.”

A version of this legislation was first introduced in 2016, and in the interim the U.S. Centers for Medicare & Medicaid Services (CMS) has acted on some of that bill’s provisions, including removal of restrictions on telehealth services for mental health, stroke care, and home dialysis.

The newly introduced version would permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. It would also allow health centers and rural health clinics to provide telehealth services, and give the Secretary of Health and Human Services permanent authority to waive telehealth restrictions, among other provisions.

During periods of national disaster, the U.S. Department of Health and Human Services has the authority to waive regulatory requirements under section 1135 of the Social Security Act, allowing CMS to issue waivers relaxing conditions of participation (CoPs) for hospices and health care providers, including expanded use of telehealth for patient care. Telehealth visits have helped providers maintain continuity of care while limiting in-person contact that could spread the COVID-19 virus.

During the pandemic, hospices have been able to provide interdisciplinary services via telemedicine or audio as long as the patient is receiving routine home care level of care and those telemedicine services which are audio-only services are capable of meeting the patient and caregiver needs.

The $2.2 trillion CARES Act, designed to help the economy and essential industries weather the impact of the pandemic, also contained provisions related to hospice telehealth, including permitting practitioners to recertify patients via telemedicine appointments rather than face-to-face encounters.

Last year President Donald Trump signed an executive order that among other provisions directed CMS to review the temporary steps taken during the pandemic to determine which could be extended and to propose a rule to that effect. The number of rules affecting hospices that would be extended remains to be seen. The current status of that review under the new Biden administration is unclear.

“The COVID-19 pandemic has demonstrated telehealth’s utility in delivering essential care,” Cardin said. “As we look beyond the pandemic, it is clear that telehealth will be a crucial tool in addressing health disparities for populations with diminished access to care.”