Over the past few months, in response to the pandemic, providers have continued to care for patients via virtual care and digital health technologies. Due to the temporary regulator actions that removed long-standing barriers, telehealth has become a vital tool to ensure that patients still have access to the care they need. Simply put, telehealth has saved lives and helped reduce the spread of the virus.
Legislation adopted by Congress in response to COVID-19 provided waiver authority to the Department of Health and Human Services (HHS) to bypass statutory restrictions on Medicare coverage of live voice and video (telehealth) interactions between providers and patients. It is now vital that Congress build on this important progress to enable digital health care innovations to continue as a tool available to our providers fighting to defeat COVID-19. Congress must also act to ensure the current digital health and telehealth tools available to providers be made permanent in order to prevent the sudden unavailability of these tools for Medicare patients should the national public health emergency (PHE) expire in July.
Section 3704 of the Coronavirus Aid, Relief and Economic Security (CARES) Act provides for Medicare covered telehealth services to be furnished by Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs). Similarly, the response packages enacted a general waiver provision enabling HHS to temporarily waive outdated "originating site" and geographic restrictions in Section 1834(m) of the Social Security Act on Medicare's coverage of telehealth enabled services. Likewise, the CARES Act also included an important update allowing for the use of telehealth technology to conduct the face-to-face visit required to recertify a Medicare patient's eligibility for hospice care.
Using these legislative provisions and existing regulatory authority, HHS took numerous steps to remove barriers so Medicare patients—a population that is particularly vulnerable to COVID-19—can use telehealth and remote patient monitoring (RPM). In part because of these regulatory and statutory changes, patients have turned to digital health platforms, tools, and services to consult with caregivers in greater numbers as clinicians seek to treat their patients at home and avoid calling them into an office or hospital where they could risk exposure or exposing others to the novel coronavirus.
As a result of Congressional and HHS actions, telehealth usage has increased dramatically, with private insurance claims for telehealth increasing from nearly zero to an average of about 15,000 per week. three-quarters of U.S. hospitals are using digital technology to reach their patients via video, audio, chat, or email. Patient use of telehealth is up from 11% in 2019 to 46% this year, with 76% of consumers saying they are interested in using telehealth in the future. Without question, the broadened availability of digital health technologies, such as telehealth video calls, have proven to be a key in limiting the spread by keeping people at home.
Congress must act before the end of the PHE to ensure coverage and payment of Medicare services furnished using audio and video technology continue, otherwise these digital and telehealth tools will once again be limited to narrowly defined rural areas only. Moreover, if Congress does not act, Section 1834(m) of the Social Security Act would again largely prohibit coverage of services provided to patients in their homes thus requiring Medicare beneficiaries to travel to health care sites to access care – increasing their exposure risk to the coronavirus despite being able to access this care in their home today.
Congress must act through separate legislation or as part of the next legislative package in response to COVID-19 to protect Medicare patients and ensure that have access to their needed medical care. Congress must safeguard the expanded digital health capabilities being utilized by Medicare patients and their providers. Any failure to act would be a grave mistake for government and be a critical blow to our national effort to defeat the coronavirus.
URAC is proud to join the nation’s leading organizations in urging Congressional action to preserve access and protect patients.