Key Telehealth Law Update: Advancing Telehealth Beyond COVID–19 Act of 2022

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On July 27, 2022, Congresswoman Liz Cheney (R-WY) and Congresswoman Debbie Dingell (D-MI) celebrated the House passage of their Advancing Telehealth Beyond COVID–19 Act of 2022. It extends critical Medicare telehealth policies and is implemented during the pandemic through December 31, 2024. The extension would include telehealth and allow US citizens to benefit from other healthcare technologies. It is particularly favorable to practitioners offering telebehavioral health to Medicare beneficiaries.

Representative Liz Cheney commented:

This legislation, which I have been proud to work on for over two years, will expand Telehealth capabilities by removing geographic requirements. It also expands originating sites so Medicare beneficiaries have better access to care, can obtain care from more practitioners, and can receive audio-only telehealth. – Rep. Liz Cheney (R-WY)

Representative Dingell also issued the following statement:

This legislation brings us one step closer to permanently expanding telehealth services and allowing Americans to continue to access critical health care from the comfort of their home.” – Rep. Debbie Dingell (D-MI)

Telebehavioral Health Background: Medicare Telehealth Policies and Reimbursement

In March 2020, Congress authorized bipartisan legislation to expand Medicare telehealth policies and services. Current telehealth provisions expire 151 days (5 months) after the public health emergency (PHE) ends. The current legislation addresses several concerns about Medicare benefits and is of particular note to telebehavioral health practitioners.  

The Act is endorsed by the American Medical Association (AMA). Jack Resneck, Jr., MD, President of the AMA, issued the following statement supporting the legislation: 

From the continuity of care, broadened access to care, and removing geographic and originating-site restrictions, our hope is that the flexibility afforded during the public health emergency will be permanent. This legislation offers an essential step in that direction by extending telehealth benefits to December 31, 2024. We urge the Senate to act on this bipartisan bill and for Congress to build on this success.

Quick Summary of  Advancing Telehealth Beyond COVID–19 Act of 2022  

This updated Advancing Telehealth Beyond COVID–19 Act of 2022 would extend critical Medicare telehealth policies that were initially authorized at the start of the COVID-19 pandemic through 2024. Excerpted from a press release on Representative Cheney’s website, the bill would allow for the two-year continuation of: 

• Increased locations from which a beneficiary may receive telehealth services by removing geographic restrictions and expanding originating sites. 
• Expanded telehealth services are offered by qualified physicians and practitioners, including physician assistants, nurse practitioners, clinical nurse specialists, nurse-midwives, clinical social workers, clinical psychologists, registered dieticians, and nutrition professionals. 
• Medicare reimbursement of telehealth services provided by physicians and practitioners working for Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs). 
• Mental health services are furnished through telehealth for up to six months without an in-person meeting. 
• Audio-only telehealth services ensure seniors and rural patients who may not have internet connectivity can receive the care they need. 
• Expanded access to telehealth services for recertification of hospice care eligibility during an emergency period. 

The bill passed with broad bipartisan support with a vote of 416-12. At the time of this writing, it has been read twice by the Senate and referred to the Committee on Finance. See an up-to-date progression of its status here.

American Hospital Association (AHA) Comments on Telemental Health

In a related development, Stacey Hughes, the Executive Vice President of the American Hospital Administration, sent a July 19, 2022 statement to Congress regarding telemental health and telebehavioral health in a letter to the Senate Committee on Finance addressing mental health care and telehealth.

The comments begin:

On behalf of our nearly 5,000 member hospitals, health systems, and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses, and other caregivers — and the 43,000 healthcare leaders who belong to our professional membership groups, the American Hospital Association (AHA) appreciates the opportunity to provide feedback on the Senate Finance Committee’s discussion draft addressing mental health care and telehealth.

It continues:

AHA supports allowing Medicare beneficiaries who seek treatment for mental health disorders to receive their care through audio-only services. This flexibility has enabled hospitals and health systems to maintain care for numerous patients who do not have access to broadband internet or video-conferencing technology and continue to provide services when a video connection fails. Additionally, hospitals and health systems report that audio-only behavioral health services have become extremely popular with patients who are less comfortable with face-to-face visits.

AHA also supports removing the requirement for Medicare patients to receive an in-person visit before receiving mental health services through telehealth. There is no clinical basis for this requirement, and evidence shows many telemental health services are just as effective as in-person services. Removing the in-person visit requirement will improve access to mental health care for Medicare beneficiaries and provide additional options for those that might be unable to travel to a mental health provider. (Emphasis added by Telehealth.org). 

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