A bipartisan group within the U.S. House of Representatives has introduced legislation that would extend the use of telehealth flexibilities beyond the federally declared COVID-19 national emergency. The U.S. Centers for Medicare & Medicaid Services (CMS) instituted most of the temporary flexibilities via 1135 waivers.
The legislation addresses the use of telehealth throughout the health care continuum and would remove current CMS restrictions on its use, including geographic restrictions on where a patient must be located in order to access virtual services. The bill would also allow ]federally qualified health centers and rural health centers to offer telehealth, and make permanent the U.S. Department of Health & Human Services’ (HHS) temporary waiver authority for national emergencies and the 90 days after the rescinding of a public health emergency declaration.
“Prior to the coronavirus pandemic, there was still some question as to whether telehealth could be an effective alternative to going to the doctor’s office. The answer is now clear: unequivocally, yes,” said Rep. Bill Johnson (R-Ohio). “This bipartisan legislation will enable Medicare beneficiaries to continue using telehealth services when the current emergency declaration ends, and ensures that the enormous resources invested in making this technology work are not wasted. It’s time to expand high-quality telehealth services to all Americans, not roll back the progress we’ve made.”
A number of the telehealth flexibilities implemented by CMS impact hospice providers. During the pandemic, hospices may 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.
A number of stakeholders in the hospice space, as well as a group of U.S. senators have called on CMS to make these actions permanent. The agency has indicated that they are reviewing the waivers to see which can be implemented on a long-term basis.
“With these transformative changes unleashed over the last several months, it’s hard to imagine merely reverting to the way things were before. As the country re-opens, CMS is reviewing the flexibilities the administration has introduced and their early impact on Medicare beneficiaries to inform whether these changes should be made a permanent part of the Medicare program,” CMS Administrator Seema Verma wrote in the journal Health Affairs.
Prior to the emergency declaration, about 13,000 Medicare beneficiaries accessed telemedicine services during a typical week. As of the last week of April, that number had ballooned to almost 1.7 million people, Verma indicated. All told, more than 9 million beneficiaries have received a telehealth service between mid-March and mid-June.
In addition to Johnson, the bill’s sponsors include Reps. Peter Welch (D-Vt.), Rep. Mike Thompson (D-Calif.), David Schweikert (R-Ariz.), and Rep. Doris Matsui (D-Calif.).“It is clear that telemedicine is part of the future of our health care system, and should be continued as an attainable tool post-pandemic. Telehealth services are allowing society to become safer, healthier, and more effective at delivering the care patients deserve,” said Schweikert. “This legislation will ensure individuals have a choice in how they receive their care, and I am proud to give patients the care and control they deserve through this affordable innovation.”