The American Telehealth Association is working with Congress and several federal agencies to shape the fate of policies and payments for telehealth services that have gone viral during the COVID-19 pandemic.
why does it matter
Now that President Joe Biden has declared the COVID-19 pandemic over, the ATA’s Telehealth Awareness Week Policy Update webinar explored how federal and telehealth policies could affect the state as Congress decides whether to end the health emergency Public (PHE) or not.
Federal priorities for telehealth have evolved as the pandemic spreads with the lifting of restrictions by Congress to decide whether restrictions on certain restrictions should be lifted permanently.
PHE must be reviewed every 90 days, so Congress will have to reconsider the renewal by mid-October, according to policy experts presenting during Wednesday’s online event.
“as we know, [President] Biden has said in recent days that the pandemic is over, so the public health technical emergency will likely end sometime in the very near future.
Quinn Shen, strategic advisor at Tusk Ventures and state policy advisor at ATA and ATA Action, said telehealth payments and provider practices are highly regulated at the federal level.
But even if Medicare providers don’t provide Medicare services, “Medicare policy is deteriorating,” Herber added.
For example, prior to the pandemic, patients had to be in a rural area of a hospital or clinical setting to receive reimbursement for telehealth.
“This is the status quo at the moment – as long as the public health emergency of COVID-19 is in place,” Herber explained. But within five months, “all of these concessions disappear automatically unless Congress does something.”
Policy approaches can be different in different contexts, noted coordinator Alexis Gilroy, co-chair of the health care and life sciences practice at Jones Day. “Where did you come to it based on the exact path it is on?”
With regard to the policy of telehealth at the state level, there are multiple priorities for the state because states differ in their approaches to the requirements for telehealth coverage of public and private health plans, reimbursement for services provided via telehealth, and eligibility to provide refundable services.
Countries also differ in how they regulate synchronous and asynchronous telehealth and remote patient monitoring. They differ on what types of providers can provide telehealth, what establishes a valid patient/provider relationship and whether out-of-state practitioners can remotely treat patients in the state without a license, Shine explained.
“We have a mixture of 50 different countries here,” she said.
The ATA has focused on developing a consistent regulatory framework so that telehealth services can be deployed across states and fully utilized.
“The ATA is committed to policies that are neutral,” she said, rather than dictating which tools clinicians choose to use to deliver telehealth. The ATA is pushing for fair payment for telehealth and home health services as well as licensing flexibility across state lines.
“It’s really aligning our state frameworks with the 21st century model of care,” she said, and states are moving fast. There have been hundreds of pieces of legislation to update the state’s telehealth policies.
The organization is also working with the US Drug Enforcement Agency and Congress to address the future of controlled substance prescribing online.
Shen said many barriers to telehealth policy are based on perceptions that telehealth is somewhat substandard and that in-hospital care is romanticized, but telehealth often provides care where there was no prior access to care health.
“We need to recognize the access gaps that telehealth can fill” and learn about the protective barriers that exist in telehealth as they are with other care settings, Shen said.
Like retail providers like CVS, Amazon, and others are entering the space through mergers and acquisitions, and will also have an impact on the direction of telehealth policy, including how to protect patient data that these companies will have greater access to.
But with more stakeholders pushing for telehealth statewide, “having a wider tent now helps show the different groups of patients that can be served here and brings more focus,” Shen noted.
Under the CARES Act, Congress gave the Centers for Medicare and Medicaid Services the power to waive certain restrictions on Medicare coverage for telehealth.
The agency was able to remove geographic restrictions, expand in-home care, increase the amount of services covered by Medicare via telehealth and more.
Additional legislative proposals, including The Telehealth Benefits Expansion Act for Workers, the Telehealth Extension Act, and others propose to expand access to telehealth.
“Throughout the pandemic, telehealth has proven to be a vital tool for Americans to receive quality, timely care from the comfort of their homes,” Tim Wahlberg, R-Mitch, said while introducing the bill at the Capitol in March.
“For rural communities in particular, telemedicine has helped remove barriers to care, expand access to specialists and improve health outcomes.”
“There is an urgency [for Congress] to act – do not wait until four months and 20 days after the end of the epidemic; “We need some stability,” Herber said.
“We like to make it permanent, and a lot of these policies we’ve been asking for since before the pandemic, so it’s not really new,” she concluded.
Andrea Fox is Senior Editor at Healthcare IT News.
Healthcare IT News is a HIMSS publication.
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