Stakeholders To Congress: Make PHE Telehealth Policies Permanent

Inside Health Policy

July 27, 2021 9:05 am

More than 400 organizations, mostly health care providers and technology companies, pushed for COVID-19 telehealth flexibilities to be made permanent in a letter sent to congressional leadership Monday (July 26).

Telehealth has exploded since the onset of the COVID-19 public health emergency, thanks in part to temporary flexibilities from CMS that allow providers to be reimbursed for telehealth at parity with in-person services and make it easier for telehealth to be used by both providers and beneficiaries.

But the letter points out that most of these flexibilities are limited to the duration of the PHE, and Congress has not yet acted to protect access to telehealth into the future.

The organizations argue that telehealth is not a “COVID-19 novelty,” and say that if Congress doesn’t act, losing telehealth options could have a chilling effect on health care availability throughout the country.

“It is far past time to update our telehealth laws. These are arbitrary restrictions that should be removed,” Jen Covich Bordenick, CEO of eHealth Initiative, said in a statement following the letter’s release. “The pandemic highlighted just how outdated our current law is. Congress needs to take immediate action to ensure millions of patients do not lose access to care delivered via telehealth.”

The letter comes after a bipartisan group of lawmakers sent a letter to HHS Secretary Xavier Becerra urging him to work with Congress to permanently expand telehealth post-PHE. Becerra has said he does not plan to go backwards on telehealth coverage but could use assistance from Congress.

CMS also proposed earlier this month to extend limited telehealth services for mental health after the PHE. This would include allowing audio-only telehealth for mental health services but only when the provider has the capacity for two-way, audio-visual communications, and requiring an in-person visit before tele-mental health services can begin and at least once every six months after.

The groups that signed onto the letter say the proposed requirement for an initial in-person visit isn’t based in clinical support and could further health inequities. They ask Congress to step in.

The groups want geographic and originating site restrictions for telehealth removed as well. Many states have already gotten rid of these restrictions on their own books.

“Removing geographic and originating site restrictions only to replace them with in-person restrictions is short-sighted and will create additional barriers to care,” the letter says.

The letter also calls on Congress to give HHS more authority to determine who can provide services through telehealth, and to add or remove telehealth-eligible services through regulation. Congress should allow HHS to reimburse for audio-only telehealth and other modalities, too, the letter says.

Additionally, the groups want Congress to make sure Federally Qualified Health Centers, Critical Access Hospitals, and Rural Health Clinics can still provide telehealth services post-PHE. This includes offering appropriate reimbursement to the provider types.

Given restrictions written into the Social Security Act, congressional action is needed to give HHS authority to extend these temporary policies, the letter says.

Claire Ernst, director of government affairs for the Medical Group Management Association, which signed onto the letter, said MGMA’s members are nervous about facing a so-called telehealth cliff as the end of the PHE looms. So far, the emergency designation and the flexibilities it allows are likely to be extended through 2021, but that means Congress should act soon, Ernst said.

“[W]e would definitely want to see legislation move on this before the year is over,” Ernst said in an email.