Telehealth groups urge Congress to adopt long-term virtual care solution

Diving brief:

• Telehealth advocates and providers are urging Congress to let Medicare permanently pay for telehealth services, as the longest government shutdown in U.S. history stretches into its second month.
• The most recent short-term expansion of telehealth flexibilities expired at the end of September after Congress failed to reach consensus to fund the government. Access to virtual care and reimbursement have since been disrupted. Now, more than 450 groups are pushing lawmakers to avoid a temporary fix in their next legislative package in a letter sent Tuesday to House and Senate leaders.
• The letter comes amid another looming telehealth deadline: flexibilities allowing remote prescribing of controlled substances are set to expire at the end of 2025.

Dive overview:

Medicare telehealth flexibilities were first adopted during the coronavirus pandemic to preserve access to care as clinicians attempted to limit in-person contact with patients.

The changes include policies such as eliminating geographic restrictions for virtual care and allowing all eligible Medicare providers to offer telehealth. Prior to the public health emergency, telehealth coverage in Medicare was largely limited to beneficiaries living in rural areas or certain types of facilities or services.

Although these policies are widely popular with lawmakers on both sides of the aisle, the flexibilities have often come close to expiration over the past year. In December, Congress only continued these policies until March, after a bill for a longer extension collapsed at the last minute.

An additional short-term extension kept the flexibilities in place for a further six months until September. However, this fall, lawmakers reached an impasse on a funding bill, allowing the government to shut down and telehealth policies to lapse.

This has created significant uncertainty for providers, who have had to scale back their telehealth offerings for Medicare beneficiaries or continue without knowing whether or not they will be reimbursed, experts say.

The letter sent Tuesday by hundreds of organizations — including the American Medical Association, the Alliance for Connected Care, the Cleveland Clinic and Intermountain Health — says lawmakers’ “cycle of temporary fixes” has left providers and patients facing frequent interruptions in care.

“The breadth of support behind this letter highlights how critical Medicare’s permanent telehealth policy has become for patients and providers,” Chris Adamec, executive director of the telehealth nonprofit Alliance for Connected Care, said in a statement. “We cannot continue to rely on short-term extensions that leave clinicians and seniors in uncertainty. »

Meanwhile, another telehealth cliff looms on the horizon. Pandemic-era flexibilities that allowed clinicians to prescribe certain controlled substances without first scheduling an in-person appointment are set to expire soon.

These flexibilities were recently extended through 2025. Days before President Joe Biden left office, his administration proposed a framework that would govern telehealth prescriptions for controlled substances, but some industry groups argued that the regulations would be too onerous for providers and the rule was not finalized.

Expanding prescribing policies again would give regulators more time to make critical changes to the proposal, said ATA Action, the advocacy arm of the American Telemedicine Association.

“The administration has the authority to extend it immediately, regardless of the shutdown, to protect patients, providers and access to life-saving treatments,” Kyle Zebley, executive director of ATA Action, said in a statement. “We urge Congress and the administration to take rapid action to achieve this and work with the telehealth community on a permanent, practical, patient-centered regulatory framework.” »