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July 16, 2020 03:18 PM

House bill would cut Medicare restrictions on home telemedicine

Jessica Kim Cohen
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    House telehealth caucus leaders have introduced a bill designed to make some telemedicine flexibilities promulgated during the COVID-19 pandemic permanent.

    Industry groups including the American Telemedicine Association and the Healthcare Information and Management Systems Society have already rallied around the proposal.

    The bill, dubbed the Protecting Access to Post-COVID-19 Telehealth Act, would make it easier for Medicare beneficiaries to receive care at home, as well as giving HHS authority to waive requirements during future emergencies.

    The proposed legislation would authorize CMS to continue reimbursement for telemedicine services for 90 days after a public health emergency ends, as well as giving HHS the authority to waive telemedicine restrictions in Medicare during future emergencies and disasters, as the agency did for COVID-19.

    It would also remove some originating site requirements for Medicare beneficiaries, such as by making a patient's home an eligible site to receive care via telemedicine.

    "Since the spring, many patients who need routine care have been using telehealth to see their doctors without increasing the risk of spreading coronavirus and many face an abrupt end to this practice after the crisis is over," said Rep. Mike Thompson (D-Calif.), founder and co-chair of the Congressional Telehealth Caucus, in a statement.

    Thompson introduced the proposed legislation with Reps. Peter Welch (D-Vt.), Bill Johnson (R-Ohio), David Schweikert (R-Ariz.) and Doris Matsui (D-Calif.).

    "We know telehealth can be an essential bridge in delivering care, particularly during a crisis and today we are working to ensure telehealth continues in a post-coronavirus world," Thompson said.

    The Protecting Access to Post-COVID-19 Telehealth Act also would require CMS to prepare a report for Congress within 180 days of an emergency period where Medicare telemedicine restrictions were modified, describing telemedicine use during the period, including costs, health outcomes and racial disparities.

    Telemedicine use has soared in response to the COVID-19 outbreak, helped by a host of regulatory flexibilities from Medicare. That has led healthcare providers to voice concern that patients will lose access to virtual care services when the public health emergency ends, calling for CMS to keep expanded Medicare reimbursement in place after the outbreak subsides.

    HHS officials have said the agency is reviewing possible steps to extend regulatory changes, but have stressed some statutory barriers would require intervention by Congress.

    More than 9 million Medicare beneficiaries have received telemedicine services during the pandemic, according to CMS Administrator Seema Verma. In the last week of April, nearly 1.7 million beneficiaries received telemedicine services, up from roughly 13,000 beneficiaries that received telemedicine services per week before the public health emergency.

    It remains to be seen whether telemedicine interest remains at the same level after the pandemic subsides; early research has indicated telemedicine visits have already been on the decline since many hospitals resumed non-emergency care in April.

    Several industry groups have already voiced support for the legislation, including the Advanced Medical Technology Association, the Alliance for Connected Care, ATA, the eHealth Initiative, HIMSS and the Health Innovation Alliance.

    "Many healthcare organizations and their patients have welcomed the benefits that telehealth provided during the pandemic and they want them to continue," said John Kravitz, chair of the College of Healthcare Information Management Executives' board of trustees and chief information officer at Geisinger Health, in a statement. "Extending telehealth flexibilities beyond the public health emergency will allow clinicians to continue to safely treats patients while battling this highly contagious disease."

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