The Department of Health and Human Services will seek to sustain and expand access to telemedicine after the federal government declares the COVID-19 public health emergency to be over, Secretary Xavier Becerra said Friday.
Telehealth proved critical to Medicare beneficiaries during the first year of the pandemic, according to a report the HHS Office of Inspector General released Tuesday.
"We would be really closing our eyes to a new form of quality healthcare if we did not expand authorities for telehealth to be available to Americans," Becerra said during a news conference.
"That means giving providers and doctors more authority on what they can and cannot dispense both virtually and post the visit," Becerra said. "We're going to work as aggressively as we can to get as much authority as possible so that the providers of that telehealth have an opportunity to save lives."
The Centers for Medicare and Medicaid Services significantly relaxed restrictions on telemedicine during the pandemic. Beneficiaries can now use telehealth in their homes because authorities suspended a requirement that they travel to rural health facilities to speak with providers in remote locations for most services. Medicare also expanded the number of allowable telehealth services by 146 and permitted providers to bill the same as for in-person visits.
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Many of these flexibilities are tied to the public health emergency designation, which is due to expire April 16 unless President Joe Biden renews it. At least one more 90-day extension is likely: The federal government informed states they would receive at least 60 days' notice before the public health emergency lapses. In addition, Congress extended Medicare coverage of telehealth services for 151 days past the end of the emergency.
More than two in five Medicare beneficiaries used telehealth between March 1, 2020 and Feb. 28, 2021, according to the HHS OIG report. Nearly half of telehealth usage by Medicare enrollees during those months was for routine appointments with primary-care doctors or specialists. These patients used 88 times as many telehealth services during the pandemic's first year than they had in the prior full year.
Telehealth use among Medicare enrollees peaked during the early months of the pandemic. In April 2020, the program recorded 17.6 million such visits; seven months later, that fell to 7.8 million. Despite the decline, telehealth usage remained historically high by February 2021, the OIG found.
As they wait for further action from Biden and Congress, healthcare trade organizations and patient advocacy groups argue HHS can take steps on its own. That could include ensuring CMS aligns its alternative payment models to support telehealth. CMS also could permanently authorize technical changes to telehealth rules. For example, the agency has allowed clinicians to be paid for virtually supervising medical residents during the public health emergency, and that could be extended.