The $1.7 trillion spending bill Congress unveiled this week includes an extension of HHS rules that made telehealth more accessible during the COVID-19 pandemic, but falls short of permanently extending the flexibilities. Despite that, telemedicine groups cheered the legislation, while still reminding lawmakers there’s more to do.
“Today, our Congressional telehealth champions on both sides of the aisle came through,” Kyle Zebley, SVP of public policy at the American Telemedicine Association, said in a statement. “We asked Congress and they listened.”
The omnibus bill extends Medicare telehealth provisions put in place during the COVID-19 public health emergency for another two years, including a two-year delay in implementing an in-person screening requirement for Medicare telemental health and a two-year extension of a program allowing providers to provide acute hospital-level care at home.
It also extends a provision allowing employers to offer telehealth services pre-deductible to employees with a high-deductible health plan and a health savings account.
Telehealth Access for America “applauds congressional leaders for demonstrating their commitment to the millions of patients who have come to rely on telehealth services by extending critical flexibilities in proposed omnibus legislation,” said TAFA spokesperson Julia Mirich.
“The inclusion of a two-year extension of Medicare telehealth and commercial market telehealth flexibilities will make a huge difference to so many Americans,” the Alliance for Connected Care said in a statement. “Bravo Congress.”
Telehealth lobbies noted they would continue to work with lawmakers to codify telehealth access into U.S. law, with the ACC saying it is “confident” that in two years Congress will have the evidence it needs to make telemedicine a permanent part of Medicare.
Before the COVID-19 pandemic, telehealth use in Medicare was restricted to specific locations and circumstances, like for beneficiaries in rural areas or patients already in a hospital. As the coronavirus spread in early 2020, hampering patients’ ability to access in-person medical services, the Trump administration eased barriers to virtual care, allowing Medicare to temporarily reimburse telehealth appointments at the same rate as in-office visits, among other flexibilities. Private payers followed suit, and telemedicine visits soared as a result.
Despite telemedicine enjoying bipartisan support, lawmakers have debated which flexibilities should be made permanent, with big questions about cost, timing and the potential for fraud and abuse.
The two-year extension in the omnibus bill kicks the can down the road and gives politicians more time to assess the issue, but telehealth has become too interwoven into American care delivery to be rolled back, according to Roy Schoenberg, CEO of Boston-based telemedicine company Amwell.
Consumer use of telehealth skyrocketed during the pandemic, reaching a high of 13% of all private medical claims in April 2020, according to data maintained by Fair Health. Since then, usage has fallen to 5.4% in September, but still remains elevated from pre-pandemic levels, and patients report high levels of satisfaction with the modality.
“Good luck to any politician in Washington or running for state level or whatever it is, who’s going to say, ‘We are going to pass a bill to restrict your access to telehealth-based services’,” Schoenberg told Healthcare Dive.
Proponents of telemedicine ramped up lobbying as lawmakers considered what to include in the year-end spending bill. The ATA spent $120,000 in the third quarter of 2022 alone, four times higher than its spending at the same time last year, according to Open Secrets, which tracks money in politics.
Congress is expected to vote on the omnibus and send it to President Joe Biden to be signed into law within the next week.