Bill Would Require HHS Study On Telehealth During COVID-19 PHE

Inside Health Policy

July 30, 2021 9:33 pm

Rep. Robin Kelly (D-IL) reintroduced a bill Wednesday (July 28) that would direct HHS to study telehealth’s impact on Medicare and Medicaid during the COVID-19 public health emergency and eventually submit a report to Congress. One telehealth advocate says this bill would be a positive step forward — so long as it’s paired with an extension of telehealth flexibilities.

The bill, originally introduced in June 2019, requires HHS to write an interim report no later than one year after the end of the COVID-19 public health emergency on any changes to telehealth services made under Medicare Part A and B, as well as Medicaid. The report would be submitted to the House Energy & Commerce and Ways & Means Committees, as well as the Senate Finance Committee.

“Telehealth has the potential to help equalize healthcare access for underserved populations. However, we need data to understand utilization, cost, fraud, privacy and how to serve those left behind by the digital divide. Crucial time is ticking away, and to capitalize on the benefits of telehealth technology, we must act now,” Kelly, chair of the Congressional Black Caucus Health Braintrust, said in a statement.

The report would have to include a summary of how all health care services under Part A and B were used during the public health emergency, including the number of telehealth visits broken down by the number of audio-visual visits versus audio-only, and those delivered at a Federally Qualified Health Center, Rural Health Clinic or Community Health Center. A summary of in-person outpatient visits, inpatient admissions and emergency department visits should also be included in the report, the bill says.

The report would include a description of how use patterns for these care settings have changed over the PHE compared to use trends before the PHE.

Additionally, HHS would report out an analysis of Medicare telehealth use, access and outcomes during the PHE broken down by race and ethnicity, geographic region and income level, as well as the zip codes of where providers were when delivering services.

Descriptions of telehealth spending and saving under Parts A and B, any changes in patient access to care because of telehealth and any privacy concerns related to telehealth during the PHE would also be included in the report, as would a comparison of telehealth fraud and in-person service fraud identified by HHS during the PHE.

HHS could consult with consult with patients, tribal groups, patient advocacy organizations, medical professionals, public and private payers, and other relevant stakeholders to conduct the study, the bill says. The agency should make an effort to incorporate as many racially, ethnically, geographically and professionally diverse perspectives as possible.

A Medicaid telehealth report would also have to be submitted to Congress up to a year after the end of the PHE. This report would include items such as any changes made to telehealth benefits under state plans or waivers during the PHE, a summary of how all health care services were delivered and a description of how use patterns have changed.

Stakeholders have been urging more Congressional action on telehealth, fearing a so-called telehealth cliff at the end of the PHE if flexibilities put in place during the emergency aren’t continued. A group of 430 organizations sent a letter to Congressional leadership Monday (July 26) urging them to pass laws continuing the flexibilities and giving HHS more authority when it comes to telehealth.

While both Republican and Democratic lawmakers have shown support for telehealth, stakeholders are still waiting on movement, said Krista Drobac, who directs Alliance for Connected Care, a pro-telehealth coalition.

Drobac said lawmakers have expressed they don’t have enough evidence on telehealth.

“This study bill is actually perfectly appropriate to be included into an extension, because we need to have an extension, in order to give us time to publish the research,” she said. “And we need time to see what happens to telehealth in non-pandemic times.”

President Joe Biden has indicated he plans to extend the PHE until the end of 2021, meaning Congressional action is necessary before the end of the year to avoid a telehealth cliff. Congress is expected to be focused on the bipartisan infrastructure package and a budget reconciliation bill for the rest of the year, though. A telehealth extension could be attached to a spending bill, Drobac said.

The PHE could also be extended into mid-2022, Drobac said, meaning there could be more time for Congress to pass telehealth extensions if the 2021 comes and goes without action.