Dive Brief:
- Provider and telehealth groups are urging Congress to take action on Medicare virtual care flexibilities as the sector hurtles toward another deadline when the policies could expire.
- The American Medical Association, one of the nation’s largest healthcare lobbying groups, on Monday pressed lawmakers to make the pandemic-era telehealth policies permanent, arguing a “repeated cycle of temporary extensions” has undermined access to care.
- The flexibilities, which expanded reimbursement for telehealth in Medicare, are set to lapse on Jan. 30 — just a few months after the coverage policies were reinstated following the government shutdown this fall. “We are counting on our government champions to find a permanent solution or at least to establish a long-term extension for these telehealth waivers,” Alexis Apple, vice president of federal affairs at the American Telemedicine Association, said in a Tuesday statement.
Dive Insight:
The telehealth flexibilities were first enacted during the COVID-19 pandemic in a bid to preserve access to care while limiting in-person contact.
The policies changed the landscape for telehealth reimbursement in Medicare, where coverage was largely restricted to beneficiaries living in rural areas or for certain types of facilities or services.
Some of the flexibilities have since been made permanent, but others remain temporary — and subject to expiration if Congress fails to extend them. That’s become a significant challenge for providers over the past year, as extensions have come close to the deadline and only lasted for several months.
Then, when lawmakers reached an impasse over a spending plan last fall, the flexibilities lapsed for weeks amid the government shutdown. And when the federal government reopened weeks later in November, legislation only preserved the policies through Jan. 30.
The weeks-long expiration last year significantly reduced access to care, the AMA said Tuesday. One analysis by Brown University researchers found fee-for-service telehealth visits dropped 24% nationally during the first 17 days of the shutdown compared with July through late September.
“Since the COVID-19 public health emergency, Congress has repeatedly extended telehealth flexibilities for Medicare patients—often at the last moment—creating uncertainty for millions of patients and their physicians,” said AMA President Dr. Bobby Mukkamala. “As the current waiver deadline approaches, Congress must finally act decisively to prevent a disruptive and abrupt halt to the expanded telehealth services that have improved care continuity, chronic disease management, and access for rural and underserved communities.”
The looming deadline for telehealth comes shortly after regulators averted another pandemic-era virtual care policy lapse.
Last week, the HHS and the Drug Enforcement Administration extended flexibilities that allow providers to prescribe some controlled substances via telehealth without first conducting an in-person appointment, about a day before the changes were set to expire.
