Congress Gets Another Shot at Legislating Payment Parity for Telehealth
Two Congressmen have reintroduced a bill that would mandate payment parity for telehealth services, as well as requiring payers to cover any telehealth service that's covered by Medicare.
Source: ThinkStock
By - A pair of Congressmen are once again floating a bill that would mandate payment parity for telehealth services and require payers to cover the same telehealth services that Medicare covers.
The Telehealth Coverage and Payment Parity Act (HR 4480), introduced last month by US Reps. Dean Phillips (D-MN) and Steve Chabot (R-OH), is making its second run through Capitol Hill, having failed to pass muster in 2020. It joins dozens of bills submitted this year that aim to push Congress to set long-term connected health policy past the pandemic.
“It’s time to build a 21st century healthcare system that utilizes new technology developed throughout the pandemic to keep people well,” Phillips, who sponsored last year’s bill, said in a press release. “For many conditions, there is simply no reason for healthcare to be tied to brick-and-mortar institutions. Telehealth has allowed us to effectively deliver care during the COVID-19 pandemic, but some of the flexibilities put in place to ensure Americans have access to care will be reversed when the public health emergency expires unless Congress acts to preserve them. I’m on a mission to make our progress permanent.”
Specifically, the bill would require payers to cover telehealth services, including cost-sharing requirements such as deductibles, at the same as in-person services; prohibit restrictions on which conditions can be managed virtually; eliminate location-based restrictions on providers and guarantee that all medically necessary benefits in ERISA plans are covered by telehealth. It would also allow health plans to waive cost-sharing requirements for telehealth services related to the diagnosis or treatment of COVID-19.
Finally, it would expand the definition of a “qualifying telecommunications system,” or telehealth platform, to include the telephone, internet communications, streaming media communications “and such other systems as specified by the Secretary of Health and Human Services.”
Like so many others now before Congress, the bill looks to push telehealth adoption past the end of the COVID-19 public health emergency and give healthcare providers the leverage they need to continue using those platforms, particularly to reduce barriers to access.
The challenge lies in finding a formula that would allow providers and payers to work out agreements on reimbursement that define the value of telehealth, and to create standards that improve workloads, boost clinical outcomes and reduce wasteful expenses and unnecessary use.
