Senate health committee Chair Lamar Alexander (R-Tenn.) said on Wednesday that he wants to make permanent two telehealth changes brought about by the COVID-19 pandemic: nixing the so-called originating site rule and expanding the scope of reimbursable services.
Alexander laid out his wishlist at a hearing on the issue scheduled weeks before lawmakers are expected to begin negotiations on another COVID-19 relief package.
Pre-coronavirus policy dictated that patients had to live in a rural area and access telehealth services at a doctor's office or clinic. But because of temporary changes in response to the COVID-19 pandemic, patients can receive care anywhere in the country, and can be seen remotely from their homes.
Alexander also indicated support for Medicare and Medicaid's expansion to cover nearly twice as many telehealth services. The temporary changes also allowed Federally Qualified Health Centers and Rural Health Clinics to use telehealth services.
Many of the telehealth changes made on a temporary basis extend throughout the COVID-19 public health emergency. The current designation is scheduled to end in July, but it could be renewed.
But Alexander said he doesn't support extending waivers for requirements under the Health Insurance Portability and Accountability Act, and didn't highlight pay parity as an issue of interest.
"There are privacy and security concerns about the use of personal medical information by technology platform companies, as well as concerns about criminals hacking into these platforms," Alexander said.
Carrie Nixon, the founder and lead attorney at Nixon Law Group, noted that senators didn't discuss extending pay parity for certain services much, which allows providers to be paid the same for a telehealth visit as an in-person one.
"Payment parity is going to be really important in making sure that we do continue the momentum that we have seen in telehealth adoption and implementation during COVID," Nixon said.
Alexander recently released a white paper on pandemic preparedness policies and called for legislative action before the end of 2020.
Leaving the temporary changes in limbo with an uncertain timeline stunts providers' decisionmaking and innovation in the telehealth space, Nixon said.
"The longer we remain in a land of uncertainty as to whether and which changes will remain in effect, the longer it is toward implementation and innovation," Nixon said.
Enacting COVID-19 changes on a more permanent basis has garnered bipartisan support in the Senate. A group of 30 senators led by Sen. Brian Schatz (D-Hawaii) wrote to Senate leadership asking that removals of originating site restrictions be made permanent. Some of the changes were pulled from the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act introduced last year.
Major trade groups representing hospitals, physicians, insurers, and telehealth companies endorsed the bill.