Three Legislative Efforts to Secure Telehealth’s Trajectory

Telehealth industry experts and advocates recently gathered in Washington, D.C., for the Center for Telehealth and e-Health Law’s (CTeL) 2022 Spring Summit. The biannual event brings together providers, government officials, law firms, universities, insurance companies, investors, and other industry stakeholders to share strategic guidance and tactical tools for navigating changing legal and regulatory issues related to telehealth. Founded in 1995, CTeL is a nationally recognized non-profit research organization focused on telemedicine and virtual care.

Over the course of this year’s Spring Summit sessions, three pieces of legislation were highlighted that could significantly influence the trajectory of telehealth. Caregility Clinical Program Managers Donna Gudmestad and Irene Goliash were among those invited to attend the event, where they examined trends and shared their perspectives as experienced nurses and clinical implementation professionals. They summarize key points on three recently introduced telehealth bills here.

H.R. 6202: Telehealth Extension Act of 2021

Introduced in December 2021, the Telehealth Extension Act seeks to:

• Permanently lift geographic and site-based restrictions so Medicare beneficiaries can use telehealth in the comfort and convenience of their own home or at designated health facilities offering telehealth, regardless of their zip code.
• Support the adoption of telehealth in underserved communities by ensuring Federally Qualified Health Centers, Rural Health Clinics, Indian Health Service facilities, and Native Hawaiian Health Care Systems can furnish telehealth services.
• Provide a two-year temporary extension of COVID-19 emergency telehealth waivers, including permitting providers like Speech Language Pathologists, Occupational Therapists, and Physical Therapists to furnish telehealth services; enabling Critical Access Hospitals to continue providing outpatient behavioral therapy services through telehealth; and permitting payment for appropriate audio-only services.
• Promote program integrity with guardrails for a small subset of telehealth services that have been targets of fraud without limiting patients’ access to care. The bill would require an in-person appointment within six months prior to ordering high-cost durable medical equipment (DME) or high-cost clinical laboratory tests. The legislation also authorizes CMS to audit outlier physicians ordering DME and lab tests at high rates and recover fraudulent payments. Finally, CMS will track who is billing for DME and lab tests by requiring providers to use their own National Provider Identifier when billing Medicare for a telehealth service.
• Improve disaster preparedness by providing broad authority for CMS to authorize telehealth flexibilities during future emergencies.

H.R. 4058: Telemental Health Care Access Act of 2021

Introduced in June 2021, the Telemental Health Care Access Act seeks to:

• Remove the statutory requirement, Section 123 of the Consolidated Appropriations Act of 2020, that Medicare beneficiaries be seen in-person within six months of being treated for mental and behavioral health services through telehealth.
• Require the Secretary of the Department of Health and Human Services to submit a report to Congress on the utilization of mental and behavioral health services furnished through telehealth within one year of the termination of the Federal Public Health Emergency.
• Provide additional funding to HHS’ Office of the Inspector General to conduct audits, investigations, and other oversight and enforcement activities related to telehealth.

H.R. 7053: Hospital Inpatient Services Modernization Act

Introduced in March 2022, the Hospital Inpatient Services Modernization Act seeks to:

• Provide a two-year temporary extension of the Acute Hospital Care at Home COVID-19 waiver brought on by the pandemic.
• Require the Secretary of the Department of Health and Human Services to conduct an evaluation of the Acute Hospital at Home and Hospital Without Walls waivers and issue a report with recommendations for legislation to make the waivers permanent.

Recommendations and Next Steps

CTeL,whose staff and stakeholders regularly engage with congressional offices and members of the Executive branch to discuss the impacts of federal telehealth policy, supports the three legislative initiatives. They encourage Congress to permanently lift geographic and site-based restrictions so Medicare beneficiaries can continue to use telehealth regardless of their zip code. They also endorse the provision of a two-year temporary extension of COVID-19 emergency waivers as Congress works towards a permanent solution, to allow CMS to continue to collect data on telehealth cost, utilization, services provided, and access.

Additional recommendations are that Congress work towards a bipartisan solution to ensure that individuals in rural and underserved areas continue to receive access to telemental health services without burdensome requirements. CTeL also advocates for a temporary two-year extension of Acute Hospital at Home waivers. They recommend that the Secretary of HHS evaluate the program and produce a report with legislative recommendations to permanently allow acute-level care to be furnished and reimbursed in the home via telemedicine.

You can help advocate for these telehealth initiatives by contacting your Congressional representative. Research into the efficacy of telehealth programs will undoubtedly impact the fate of these bills and others like them, as well.

“Consensus on both sides of the aisle is that telemedicine is essential,” said Goliash. “It’s important that the Congressional Budget Office and we as stakeholders have a good understanding of why these issues matter and how to appropriately allocate funding. CTeL’s support of ongoing research into the needs, costs, risks, and ROI associated with telehealth and virtual care will help to further quantify impact.”

“CTeL has done a tremendous job bringing together organizations focused on telemedicine in support of initiatives that affect not only the deliverers of virtual care but the patient recipients who benefit from it across the country,” noted Gudmestad. “Their bipartisan approach to ensuring that access to care remains in place for everyone is admirable. Now we need everybody’s support to keep telehealth momentum moving forward. Why go back to something less efficient?”