Cures 2.0 Includes Provisions to Expand Telehealth Coverage, Services

June 28, 2021 - The next phase of the 21st Century Cures Act includes several measures to boost Medicare coverage for telehealth, through both new programs and acts to permanently extend connected health freedoms enacted during the pandemic.

They’re part of the massive, 127-page discussion draft – called Cures 2.0 – released last week by US Reps. Fred Upton (R-MI) and Diana DeGette (D-CO), who helped secure passage of the original bill in 2016. Also included in the bill are measures to create a new federal advanced research agency to cure cancer, Alzheimer’s and other diseases; require the Food and Drug Administration to improve guidelines for innovative digital health technologies; and give patients greater access to their data and more of a say in the healthcare decision-making process.

The bill is years in the making, with Upton and DeGette launching a ‘Call to Action” in November 2019 to ask for help designing the new legislation. Telehealth hadn’t been a key component of early plans, but the pandemic changed their strategy a bit.

According to a four-page summary accompanying the bill, Cures 2.0 would:

• Require the Government Accountability Office to issue a report on recommendations to enhance Medicare coverage and reimbursement for innovative health technologies;
• Include the Telehealth Improvement for Kids’ Essential Services (TIKES) Act, which would help states to integrate telehealth into Medicaid and Children’s Health Insurance Program (CHIP) coverage, review the impact of telehealth on patient health and encourage better collaboration;
• Include the Telehealth Modernization Act, which would eliminate geographic and originating site restrictions in Medicare coverage of telehealth services and allow the Health and Human Services Secretary to expand the list of healthcare providers who could use telehealth and the types of services covered by Medicare;
• Include the Ensuring Patient Access to Critical Breakthrough Products Act, which would codify the Centers for Medicare & Medicaid Services’ current Medicare Coverage of innovative Technology guidelines; and
• Require the HHS Secretary to explore alternative coverage pathways for innovative technologies.

The main thrust of Cures 2.0 is the provision to create an Advanced Research Projects Agency for Health (ARPA-H) and give it a $6.5 billion budget. Upton and DeGette have been working with the White House for months on designing this agency, which would be modeled after the US military’s Defense Advanced Research Projects Agency (DARPA).

“The federal government has amazing resources at its disposal,” Upton and DeGette said in a press release last week, “and now is the time to put the full weight of those resources to use to cure some of the world’s most devastating diseases, such as cancer, diabetes, Alzheimer’s and more. Developing and delivering new lifesaving cures is a mission that must unite all of us. The Bidens know, firsthand, the pain and heartache that comes from losing a loved one to an illness, such as cancer. Like us, they’re determined to find new cures and treatments for these difficult diseases and we couldn’t be more excited to be working with them to make this dream come true.”

With Cures 2.0, Upton and DeGette are hoping to ride the coattails of 21st Century Cures Act and target a program near and dear to President Biden, securing crucial support at a time when Congress is facing a bitter partisan divide and struggling to pass legislation.

It’s also a bit of a tease for telehealth advocates who are lobbying Congress to set long-term telehealth policy. The bill includes some telehealth provisions, but falls short of the full slate of changes many are hoping will happen.

According to the Alliance for Connected Care, more than 40 bills now before Congress target telehealth expansion and coverage, many of them focused on making permanent certain freedoms enacted during the coronavirus.