US Reps Introduce Bill to Ensure Permanent Access to Telehealth

December 10, 2021 - Members of the House Ways and Means Health Subcommittee have introduced a bipartisan bill that seeks to ensure permanent access to telehealth services.

U.S. Rep. Lloyd Doggett (D-TX), who is the chair of the subcommittee, and subcommittee members Devin Nunes (R-CA), Mike Thompson (D-CA), Mike Kelly (R-PA), and David Schweikert (R-AZ) are sponsoring the Telehealth Extension Act.

The bill has been endorsed by several notable telehealth advocates including the National Rural Health Association, the eHealth Initiative, the American Nurses Association, and the American Speech-Language-Hearing Association.

The legislation aims to lift geographic and site restrictions to allow Medicare beneficiaries to access telehealth no matter where they live. Certain policies limit telehealth access to patients living in rural areas and providers practicing in specific clinics. Waivers helped lift these restrictions during the COVID-19 pandemic, but they are set to expire when the public health emergency ends.

Permanently eliminating these restrictions would make it easier for all Americans to access telehealth services regardless of their location, according to a press release issued by Doggett’s office.

The bill also incorporates recommendations from the Medicare Payment Advisory Commission (MedPAC) and would extend select COVID-19 emergency telehealth waivers for two years.

The waivers permit Medicare coverage for telehealth services provided by specialty providers including speech language pathologists, occupational therapists, and physical therapists.

Further, the temporary extension would allow critical access hospitals to keep providing outpatient behavioral therapy via telehealth and would ensure proper reimbursement for audio-only telehealth services.

“Expanded access to telehealth, permitted by emergency waivers, has transformed healthcare delivery—helping patients connect easily and safely with their physicians in a timely manner. As the pandemic enters an unpredictable new stage and emergency waives may expire, patients and providers should not face a cliff of uncertainty,” Doggett said in the press release.

Additionally, following another MedPAC recommendation, the congressmen plan to address telehealth fraud and promote program integrity in their bill.

Medicare has experienced several telehealth fraud cases, including a billion-dollar scheme in which telemedicine companies billed Medicare for unnecessary amounts of back, shoulder, and knee braces. Medicare was also billed over $2 billion in the past for fraudulent cancer genetic tests.

In order to address this fraud, the bill includes provisions that would require an in-person appointment within six months before administering expensive durable medical equipment (DME) or major clinical laboratory tests. In addition, CMS would be able to monitor and identify providers who are ordering and billing Medicare for DME and lab tests at higher-than-normal rates.

“This forward-looking bill, based on expert, independent recommendations, provides clarity, certainty, and a foundation for building a telemedicine system that expands access, preserves patient choice, and includes basic safeguards against fraud and exploitation,” Doggett said.

However, some organizations would rather see policymakers prioritize different methods to prevent fraud.

“Instead of requirements related to durable medical equipment and lab testing that could present serious access barriers to some of the most vulnerable patients, Congress should direct the [Office of Inspector General] to expand its use of advanced analytics and artificial intelligence/machine learning to prevent, detect, and end fraud and overutilization,” the Health Innovation Alliance said in a statement mHealthIntelligence.com received by email.

In addition to its emphasis on fraud prevention, the Telehealth Extension Act will prioritize increasing virtual care access in underserved communities by supporting telehealth adoption at federally qualified health centers, rural health clinics, Indian Health Service facilities, and Native Hawaiian Health Care Systems. 

What’s more, the legislation aims to give CMS the authority to enact telehealth flexibilities in any future public health emergencies.

The bipartisan bill joins the slew of recent telehealth legislation moving through Congress. The Cures 2.0 bill, introduced in the House in November, aims to expand telehealth access and coverage for Medicare and Medicaid beneficiaries.

The bipartisan Expanded Telehealth Access Act also prioritizes making permanent Medicare coverage and reimbursement policies regarding telehealth.

Additionally, a group of healthcare organizations recently launched a campaign urging Congress to preserve post-pandemic telehealth access.