Calls mount for CMS to extend telehealth waivers

By | June 6, 2020

Dive Brief:

  • Influential lobbying group American College of Physicians has asked CMS to extend its current waivers allowing reimbursement for telemedicine services at least until the end of 2021, or when a vaccine or effective treatment for COVID-19 has been developed. Currently, they are set to expire when the public health emergency passes.
  • Premier, a major group purchasing organization for hospitals and other providers, went even further, asking that the federal EMTALA law be revised so that patients can be screened remotely before even showing up at a hospital emergency room.
  • Specifically, ACP wants to remain in place pay parity and cost-sharing waivers for telehealth and audio-only telehealth services; geographical site restriction waivers; and the ability to practice across state lines, among other policies. Premier wants 24 rules in total loosened permanently, many focused on telehealth.

Dive Insight:

Many providers and patients have apparently not only grown comfortable with the hastily created exemptions for telehealth, but believe it’s the best approach for delivering basic healthcare services until the coronavirus is completely tamed.

It may also be seen as the best chance to ensure those changes, which some telehealth proponents advocated for long before COVID-19 surfaced, become permanent.

Earlier this year, CMS took extraordinary steps to loosen the regulations around the use of telehealth services, saying it was the appropriate response to ensure that patients could still receive services when the nation was locked down to stem the spread of COVID-19.

Now, little more than two months later, the use of remote care services has exploded, and ACP and Premier want many of those changes kept in place for the long term.

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ACP said it believes the “patient care and revenue opportunities afforded by telehealth functionality will continue to play a significant role within the U.S. healthcare system and care delivery models, even after the (public health emergency) is lifted,” ACP President Jacqueline Fincher wrote in the letter to CMS Administrator Seema Verma.

Premier’s leadership believes that the mettle of the relaxed regulations have been proven.

“In all practicality, these waivers were pressure tested during the pandemic, and proved to be effective at modernizing and improving healthcare delivery. Smart, effective ideas should be made permanent policy,” said Blair Childs, Premier’s senior vice president of public affairs.

In addition to relaxing rules and reimbursement for telehealth services, ACP also wants flexibility in the direct supervision of physicians working at teaching hospitals to remain in place, along with continued facility fee payments for hospital departments providing such services.

Data suggest that the adoption of telehealth services outside of Medicare and Medicaid has also been rapid among private insurers. A recently released survey by FAIR Health concluded that the number of telehealth-related claims submitted to private payers increased more than 4,300% nationwide in March compared to March 2019, while such claims in the Northeast rose by more than 15,500%.

ACP and Premier are not the only constituencies lobbying CMS to keep the changes in place beyond the immediate public health emergency. In a letter the U.S. Federal Trade Commission sent to CMS last week, it asked the agency to make some changes regarding the use of telehealth permanent.

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“Telehealth can potentially increase the supply of accessible practitioners and thereby enhance price and non-price competition, reduce transportation expenditures, and improve access to and choice of quality care,” FTC said.

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