Stakeholders Urge Congress to Take Early Action on Telehealth Access

February 26, 2024 - More than 200 virtual care stakeholders have signed a letter to Congress urging action on telehealth regulations early in the year, asking for more time to implement new policies before pandemic-era waivers expire on December 31, 2024.

The Alliance for Connected Care convened the organizations that sent the letter to congressional leaders last week, arguing that taking action on telehealth flexibilities earlier in the year “will provide much needed certainty, and safeguard against this important policy getting left behind among competing priorities at the end of the year.”

Following the onset of the COVID-19 pandemic, Congress enacted various waivers to extend access to healthcare amid in-person care restrictions. The waivers eliminated geographic restrictions on originating sites for telehealth services, allowed federally qualified health centers and rural health centers to continue providing telehealth services, lifted the initial in-person care requirements for those receiving mental healthcare through telehealth, and allowed for continued coverage of audio-only telehealth services.

Even as in-person care restrictions were lifted, virtual care proponents noted telehealth continued to play a vital role in healthcare delivery.

“Current telehealth flexibilities have played a critical role in promoting access to vital health care services including advanced specialists (e.g. oncologists) and mental health services without a previous in-person appointment,” the letter stated. “This is particularly true for patients in rural and underserved areas, patients with mobility issues, and patients with transportation or other limitations that prevent them from accessing in-person care in a timely manner.”

At the end of 2022, Congress extended these telehealth flexibilities through December 31, 2024.

The organizations believe that if Congress takes action on telehealth policy well before the expiration date, it will reassure Medicare beneficiaries, who would “otherwise wonder if they will have continued access to clinicians and services they are using virtually,” the letter stated.

Not only that, but acting early on telehealth regulation would also help strengthen the healthcare workforce by allowing for the creation of flexible virtual staffing models, support continued investment in telehealth tools and infrastructure, particularly among smaller healthcare providers, and enable health plans and employers to design and offer telehealth benefits before enrollment periods.

“Without clear guidance from Congress on a long-term approach for telehealth flexibilities, health care delivery systems will not be able to invest sufficient resources to allow maximal access to patients,” the letter stated.

The organizations that signed the letter include trade associations like the American Health Information Management Association and American Nurses Association, healthcare providers such as Trinity Health and Mass General Brigham, and telehealth companies like Amwell, Teladoc Health, and Omada Health.

2024 has been heralded as the Super Bowl for telehealth policy, and HHS has started taking steps toward finalizing some pandemic-era flexibilities.

On February 2, the agency published a final rule that makes permanent a temporary provision allowing opioid treatment programs (OTPs) to initiate buprenorphine treatment via telehealth if authorized healthcare professionals under the supervision of a program physician determine that an adequate evaluation of the patient can be, or was, accomplished through audio-only or video-based telehealth.

The rule also states that OTPs can use video-based telehealth to provide methadone treatment under the above stipulations. 

However, there are still numerous flexibilities that are up in the air. At the end of January, lawmakers sent a letter urging the Department of Health and Human Services (HHS) to work with Congress to maintain expanded access to telehealth.

The letter urged HHS Secretary Xavier Becerra “to communicate to Congress and the public the authorities, appropriations, resources, and other supports needed to achieve this goal. Ideal channels for these communications include the President’s Fiscal Year 2025 Budget, the Calendar Year (CY) 2025 Medicare Physician Fee Schedule, and upcoming testimonies before Congressional committees.”