Telehealth Lobby Focuses On Axing Geographic, Originating Site Limits

Inside Health Policy

December 17, 2021 3:06 pm

Telehealth stakeholders are “1,000% in agreement” that removing geographical and originating site restrictions top off their legislative goals for 2022, according to Kyle Zebley, American Telemedicine Association’s public policy vice president who moderated the lobby group’s policy meeting Thursday (Dec. 16). These restrictions have been waived under the COVID-19 pandemic through Jan. 16, and making that waiver permanent would increase access to care, especially for lower-income and disadvantaged communities, Zebley told Inside Health Policy.

The geographical restriction requires that the telehealth location be within a defined rural area and the originating site restriction requires that the visit occur within the four walls of a Medicare-approved site, which requires the patient to physically appear for the visit to be reimbursed.

The ATA also is working to make permanent the telehealth reimbursements currently allowed for Federally Qualified Health Centers, which provide primary and dental care in urban and rural areas, and rural health centers, which provide primary care in rural areas. There are approximately 8,400 FQHCs and 4,400 rural health centers in the United States, according to CMS, and telehealth reimbursement at these facilities is set to expire Jan. 16, 2022.

A third major policy push for ATA is repealing the in-person requirement for tele-mental health visits, which requires the patient be seen in-person within six months prior to their first visit and once a year thereafter. The in-person requirement is set to kick in Jan. 17, although even then it could be waived if the physician writes a note that an in-person visit would be detrimental to the patient.

First-dollar coverage for telehealth visits under high-deductible health plans is also high on ATA’s legislative agenda, as Health Savings Account plans will not be able to cover telehealth 100% after Dec. 31. Beginning Jan. 1, HSA plans will have to charge for telehealth visits and apply the fees to the deductible or the participants will not be able to contribute to an HSA.

ATA continues to lobby for these changes, which are included in stand-alone bills on Capitol Hill. But Zebley says attaching the reforms to a larger piece of legislation, such as a federal spending bill in February, is an option. He told IHP he “would love to see it happen in quarter one” of 2022.

The ATA also announced it is adding a new governmental relations group to its roster of special interest groups.