Policy News

New Bill Aims to Ease Medicare Restrictions on Telemental Health

A new bill introduced in Congress this week takes aim at Medicare's restrictive telehealth guidelines, with a goal to expand access to telemental health services.

Source: ThinkStock

By Eric Wicklund

- A new bill before Congress aims to expand telehealth opportunities for mental health providers.

The Telemental Health Expansion Act (HR 5201), sponsored by Reps. Doris Matsui (D-CA) and Bill Johnson (R-OH), would waive geographic restrictions in Medicare’s reimbursement guidelines for mental health services delivered via telehealth, and include the patient’s home as an eligible originating site.

“We’ve got to do a better job of incorporating technology into rural healthcare; it’s 2019, not 1989,” Johnson said in a Facebook post on November 19, the day before the bill was submitted. “The technology is there, and it’s about time we use it. And, this would be a big step forward.”

“All seniors stand to benefit from home-centered care and an environment that makes it easier to seek help,” Matsui reportedly told Politico.

The bill – whose text wasn’t available as of November 22 – is similar to several others targeting Medicare restrictions on telehealth reimbursement, including the Beneficiary Education Tools Telehealth Extender Reauthorization (BETTER) Act of 2019 (HR 3417) and the Mental Health Telemedicine Expansion Act (HR 1301). Provisions to improve telemental health coverage are also included in the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, which was reintroduced in October.

All of these bills focus on improving access to mental health services, a challenge in the US given the growing shortage of providers and a steady increase in the numbers of people needing this particular type of care. Connected health advocates have long argued that providers and patients should be able to connect through telemedicine – including mHealth apps and online virtual care portals – at the time and place of their choosing.

“Given the nature of the Medicare population, having to travel to one of the eight eligible originating sites to receive telehealth services may not be feasible,” InSight Telepsychiatry said in a recent press release supporting the CONNECT for Health Act. “In many cases, when faced with this barrier, individuals often delay care. However, if Medicare beneficiaries are able to receive services, such as telemental health, within the comfort of their own home, access to care will be significantly increased.”

Matsui has a long history of telehealth advocacy. In 2018, she introduced two bills aimed at improving access for behavioral health treatment – the Access to Telehealth Services for Opioid Use Disorders Act” and the “Improving Access to Remote Behavioral Health Treatment Act.” And in 2017, she was among a group of legislators pushing a bill to improve telehealth coverage in Medicare Advantage plans – a goal realized only recently through new rules unveiled by the Centers for Medicare & Medicaid Services, to take effect in 2020.

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