Dive Brief:
- A bill that would extend Medicare telehealth flexibilities advanced with unanimous bipartisan support in a House committee Wednesday, as lawmakers work to beat a year-end deadline when the pandemic-era rules will expire.
- The legislation would extend a number of Medicare flexibilities like removing geographic restrictions, expanding which providers can offer virtual services and allowing for audio-only telehealth care through the end of 2026. The bill will now go to the House floor.
- Though lawmakers voiced broad approval for expanding telehealth access, some noted more work needed to be done to study the effects of virtual care on vulnerable groups or the risks of fraud and abuse.
Dive Insight:
Once a niche method of delivering healthcare, telehealth use soared in Medicare during the COVID-19 pandemic as regulators loosened rules in an attempt to preserve access during social distancing.
Some flexibilities were made permanent, but others are set to expire at the end of this year — a concern for providers and telehealth groups who say uncertainty makes it difficult to fully invest in virtual care.
Telehealth is also a boon for access to care, especially for often-unreachable mental healthcare or rural communities that face long distances to doctor’s offices, advocates say.
“I think everybody understands the critical importance of this. [...] Five hours one way for a 10 or 15 minute office visit is just insane,” said Rep. Greg Murphy, R-N.C., during the Ways and Means Committee meeting.
The bill, called the Preserving Telehealth, Hospital, and Ambulance Access Act, allows federally qualified health centers and rural health clinics to bill Medicare for telehealth, delays the in-person visit requirement for mental healthcare and enables most hospice providers to use telehealth to satisfy face-to-face basic requirements for recertification.
The legislation also extends the Medicare acute hospital at home program for five years. Costs would be offset in part by transparency and compensation requirements on pharmacy benefit managers that work with Part D and Medicare Advantage prescription drug plans.
Lawmakers have shown support for extending telehealth flexibilities, but some have raised questions about cost, quality and how to ensure patients still have in-person options.
Telehealth should be a permanent part of Medicare, said Rep. Mike Thompson, D-Calif., one of the members who introduced the legislation. But an additional two years to study telehealth utilization and consider guardrails has merit.
“We have an obligation to be responsible stewards of taxpayer dollars,” he said. “And there are ways this committee can work to ensure that Medicare pays for telehealth in high-value settings, avoids unnecessary utilization and has robust anti-fraud and anti-abuse measures in place.”
