Group asks CMS to Issue Interim Final Rule to Preserve Telehealth Access

January 23, 2023 - In pursuit of reliable telehealth access for Medicare beneficiaries, the Alliance for Connected Care wrote a letter to the Centers for Medicare and Medicaid Services (CMS) requesting an interim final rule (IFR) to ensure that access to some Medicare telehealth services is not eliminated soon after the public health emergency (PHE) ends.

Some Medicare telehealth codes are set to expire 151 days following the expiration of the COVID-19 PHE. Although authorities can generally extend telehealth codes in the annual calendar year (CY) 2024 Medicare Physician Fee Schedule rulemaking, the timeline does not line up.

"We note that, if the PHE were to expire on April 11, access would end 151 days after that date – in early September – creating a gap in coverage and what we believe would be an unintended barrier to accessing vital health care services," said Krista Drobac, Executive Director of Alliance for Connected Care, in the letter to CMS. "This timeline is too rapid for CMS to address in its annual CY2024 Medicare Physician Fee Schedule (PFS) rulemaking…"

Because of this, the Alliance for Connected Care is asking CMS to issue an IFR to change dates per the Consolidated Appropriations Act, 2023.

“Most urgently, action is needed to continue beneficiary access to the Medicare services currently scheduled to expire 151 days after the expiration of the COVID-19 public health emergency (PHE). Our understanding is that this policy was developed in order to align the availability of these services with the authorities that were extended under the Consolidated Appropriations Act, 2022. Now that authority has been extended to December 31, 2024, these services should be updated to align through an IFR,” said Drobac.

According to the letter, an IFR could ensure that Medicare beneficiaries can access services in late 2023 and at the beginning of 2024.

In addition, the Alliance has asked CMS to make changes in the timelines on Category 3 codes, that is, temporary codes, as they compose the IFR. Drobac noted that this would provide patients with stability during the congressionally authorized extension of telehealth access until Dec. 31, 2024. It would also provide CMS and other organizations with time to collect data on whether providing the telehealth services covered by Category 3 codes has a clinical benefit for beneficiaries.

The Alliance for Connected Care has been involved in calls and efforts to solidify telehealth access throughout the pandemic.

In September 2021, the Alliance for Connected Care joined a group of organizations in signing a letter to CMS requesting expanded telehealth coverage for mental health and other services.

As telehealth advocates requested that rules to improve access and coverage be made permanent, they focused on telemental health services provided by federally qualified health centers, rural health centers, and critical access hospitals.

Through regulatory flexibilities, these organizations gained the ability to expand the adoption and use of connected care platforms. In the letter, the organizations argued that this has helped extend behavioral healthcare in rural areas, where access barriers abound.