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Application to Extend Telehealth Benefits for Medicare Beneficiaries and Other Story Starters

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Application to Extend Telehealth Benefits for Medicare Beneficiaries and Other Story Starters

About Karen Blum

Karen Blum is AHCJ’s Core Theme Leader in Health IT. A freelance journalist in the Baltimore area, he has written TI health stories for publications such as Pharmacy Practice News, Clinical Oncology News, Gastroenterology and Endoscopy News, General Surgery News other Infectious Diseases Special Edition.

Application to Extend Telehealth Benefits for Medicare Beneficiaries and Other Story StartersThere has been a small series of stories and news updates on telehealth this summer.

On July 26, some 430 health systems, associations and companies sent a joint letter to Congress urging lawmakers to extend telehealth benefits for Medicare beneficiaries beyond the COVID-19 public health emergency.

Before the pandemic began, Medicare only covered telehealth visits for its beneficiaries living in defined rural areas that initiated the call from a provider’s office, according to Kyle Zebley, vice president of public policy for the American Telemedicine Association (ATA), who is co-directing the effort. Thanks to provisions covered by legislation, such as the Coronavirus Aid, Relief and Economic Security Act (CARES), telehealth became a covered service for all Medicare beneficiaries, regardless of their area of ​​residence or where they started. the calls. But it was designed as a temporary measure. Unless it is made permanent, the ATA and other letter writers warned, Medicare beneficiaries and providers who have become accustomed to the service could fall into what advocates call a “telehealth cliff.”

The letter, jointly signed by groups such as the American Medical Association, Dartmouth Health, Yale New Haven Health System, and Zoom, recognized that health care organizations across the country “have dramatically transformed and made significant investments in new technologies and models of healthcare. provision of care “not only to meet the growing demand driven by COVID-19, but also to prepare for future healthcare needs.

“Without action from Congress,” they wrote, “Medicare beneficiaries will abruptly lose access to nearly all of the recently expanded telehealth coverage when the COVID-19 public health emergency ends. This would have a chilling effect on access to care throughout the US health care system, including patients who have virtually established relationships with providers, with potentially dire consequences for their health. “

“It really is so contradictory as to where our technology is now in the 21st century, and it’s because the law hasn’t been updated since 1997,” Zebley said during a recent phone interview, referencing Section 1834 (m) of the Insurance. Social. Act. While there has been good support for telehealth from both the Trump and Biden administrations, Zebley said that “there are limits that will return if Congress does not act and the public health emergency ends.”

The ATA and co-authors asked Congress to pay attention to at least four priorities:

  1. Remove restrictions on patient and provider location to ensure that all patients can access care from their homes or anywhere they choose, where it is clinically appropriate and with the proper guards and guardrails in place.
  2. Maintain and enhance the authority of the Department of Health and Human Services to determine appropriate telehealth providers, services, and modalities, to expand the list of eligible professionals who can provide clinically appropriate telehealth services or reimburse multiple telehealth modalities, including telehealth services. only audio. .
  3. Ensure that federally qualified health centers, critical access hospitals, and rural health clinics can provide telehealth services after the public health emergency, to support fair and appropriate reimbursement for these providers and better equip our system healthcare providers to address health disparities and provide care to underserved communities.
  4. Remove restrictions on Medicare beneficiaries’ access to behavioral and mental health services – to remove a new requirement that requires an in-person visit for behavioral and mental health services prior to a telehealth visit.

Journalists can find interesting stories by interviewing Medicare beneficiaries and their providers who currently use telehealth and who may lose that option. Also consult legislators to understand their support for the use of telehealth.

In other telehealth news this summer that could spark story ideas or inform your reports:

  • Illinois Governor JB Pritzker signed HB 3308, which requires insurance reimbursement parity for virtual mental health and substance use disorder services, and authorizes all telehealth to be covered through 2027, according to an article in Healthcare IT News. The bill prohibits insurers from requiring patients to attend in-person visits prior to telehealth services and requiring patients to provide a reason for choosing telehealth over an in-person visit. It also expands the early intervention services that can be provided through telehealth.
  • The Agency for Healthcare Research and Quality (AHRQ) provides a new national map which shows the percentages of households with access to broadband, computers and smartphones. You can zoom in on the individual county level in each state.
  • Lee Health in Southwest Florida Announced Waives your $ 49 fee for telehealth visits until further notice. Their service offers consultations and prescriptions (if needed) for common conditions like colds and flu, sinus infections, skin rashes, and coughs.
  • A study published on July 30 in MITER Corp.’s Telehealth and Medicine Today magazine and Mayo Clinic, with other partners, discussed the widespread implementation of telehealth during the first year of the COVID-19 pandemic by studying more than 2 billion health care claims from private insurers. More than 12 million telehealth claims were processed in April 2020, representing approximately half of all health care claims. Peak levels of telehealth use varied widely between states, the authors said, from 74.9% in Massachusetts to 25.4% in Mississippi. Each clinical discipline experienced a sharp increase in use, with the highest volume of claims in behavioral health.
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