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Senate HELP Committee Members Grapple with Making Permanent COVID-19 Telehealth Policy Changes

Published Tuesday, June 23, 2020

As the COVID-19 pandemic has dragged on over the last several weeks, the million-dollar question for many in the healthcare industry is:  What will be the fate of the temporary telehealth expansions in Medicare after the COVID-19 public health emergency (PHE) ends?  This was exactly the question that underlined the Senate Committee hearing last week titled, “Telehealth: Lessons from the COVID-19 Pandemic.”  Members of the Senate Health, Education, Labor and Pensions (HELP) Committee heard from four witnesses on the topic including: 

  • Karen Rheuban, M.D. - University of Virginia
  • Joseph Kvedar, M.D. – American Telemedicine Association
  • Sanjeev Arora, M.D. – University of New Mexico Health Sciences Center
  • Andrea Willis, M.D. – BlueCross BlueShield of Tennessee

Witnesses spoke of the importance of telehealth throughout the pandemic and its ability to deliver healthcare effectively and efficiently even prior to the PHE.  They also spoke of patient’s broad acceptance of virtual visits and remote patient monitoring and warned of the potential for patients to lose their access to healthcare if the telehealth expansions are not made permanent.  There are 31 temporary federal policy changes that have occurred related to telehealth since the PHE was declared.  As a reference, the Center for Connected Health Policy (CCHP) has prepared a chart of the most significant federal telehealth COVID-19 emergency actions, and provided their corresponding expiration date and description of needed policy change to make permanent.  

In the Senate hearing, there was the greatest interest in making permanent the expansion of originating sites to include all locations, including the patient’s home regardless of geographic rurality.  There was also interest in allowing any healthcare provider who is eligible to bill Medicare for their professional services to remain eligible for telehealth reimbursement.  Current statute restricts eligible telehealth distant site providers to a set list of eight distinct providers (i.e. physicians, nurse practitioners, psychologists. See complete list here). Concerns around the digital divide, specifically the lack of technology, digital literacy and access to high speed internet in some rural, underserved and low-income communities was also discussed in relation to the prospect of making audio-only telephone reimbursement permanent, as well as the need to improve high speed internet connections.  Private payer reimbursement parity for telehealth was also discussed, with BlueCross BlueShield of Tennessee fielding questions regarding their permanent expansion of parity pay for telehealth delivered primary, specialty and behavioral health care services for all in-network providers.

This hearing comes as many policymakers will have to grapple with whether or not to approve several telehealth bills currently making their way through congress seeking to make permanent and/or adjust the current telehealth reimbursement policies in Medicare or in private insurance plans.  These bills include:

  • S 3988 - Amends the Public Health Service Act with respect to telehealth enhancements for emergency response.
  • HR 7187 - Provides for permanent payments for telehealth services furnished by federally qualified health centers and rural health clinics under the Medicare program.
  • HR 7078 – A study to determine the effects of changes to telehealth under the Medicare and Medicaid programs during the COVID-19 emergency.
  • S 3792 - Requires parity in the coverage of mental health and substance use disorder services provided to enrollees in private insurance plans, whether such services are provided in-person or through telehealth.
  • HR 6792/S 3998 - Simplifies payments for telehealth services furnished by federally qualified health centers or rural health clinics under the Medicare program, and for other purposes.
  • HR 7233 - Directs the Secretary of Health and Human Services and the Comptroller General of the United States to conduct studies and prepare a report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency.
  • HR 3741:  Requires ERISA plans to cover telehealth services at parity for the duration of the PHE.

* Not a complete list.  See CCHP’s legislative tracker for full list of federal bills.

Visit the HELP Committee’s webpage for a full recording of the hearing.  For a quick reference chart on the federal telehealth policy changes that have been implemented since the COVID-10 emergency and a breakdown of the policy steps to make the change permanent, see CCHP’s federal COVID-19 Emergency Actions chart.