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Research & Telehealth Legislation Introduced to Expand Telehealth in Rural Areas
Several studies have been funded by the CARES Act since the start of the COVID-19 pandemic to examine the disparities experienced by rural area dwellers in their access to healthcare. Telehealth legislation is often based on these studies to justify the allocation of federal and state dollars to remediate existing telehealth disparities. Telehealth practitioners in the US are encouraged to follow these legislative activities to position themselves for what most assuredly will be fruitful opportunities for telehealth service expansion in the short-to-mid term.
For example, recent research from the University of Michigan’s Institute for Healthcare Policy and Innovation (IHPI) was conducted with the hope findings would aid state policymakers in designing interstate telehealth legislation. The data were collected from older adults covered by Medicare before and during the first year of the pandemic. Researchers found telehealth disparities for people living in rural areas, with 17% of rural older adults with traditional Medicare attending at least one telehealth appointment between 2019 and 2021, as opposed to 26% of non-rural older adults. The study also reported that 18% of rural residents benefited from interstate telehealth legislation. By comparison, only 13% of non-rural residents used interstate healthcare.
Despite the focus of the study on traditional Medicare recipients, the study’s additional data analyses may have important implications for Medicare Advantage, private insurance, and Medicaid beneficiaries in the future.
It may be important for the reader to note that regardless of whether state licensure laws allow interstate visits, some health insurance plans or health systems may refuse coverage for telehealth. Most state laws do not require private insurers to pay for telehealth. One is likely to find that a particular company pays for telehealth in one state and not another, and that payment practices may ebb and flow within individual states as well.
In the remainder of this article below, several related bills will be summarized and key links provided for the interested reader.
Congressman Kelly Armstrong introduced the telehealth bill HR 7876, the Connecting Rural Telehealth to the Future Act, on May 24. It is focused on extending the federal telehealth flexibilities included in the recent federal budget package until the end of 2024. This rural telehealth bill removes the geographic requirements and expands the eligible originating sites and providers for telehealth services. The bill also includes extensions to the telehealth services and provides telehealth reimbursement to:
- Federally Qualified Health Centers (FQHCs)
- Rural Health Clinics (RHCs) and
- Critical Access Hospitals (CAHs).
* Bill HR 7876 made the audio-only coverage and payment parity permanent under Medicare for all Medicare providers.
The Restoring Hope for Mental Health and Well-Being Act of 2022 has been introduced to provide a grant for pediatric mental health care telehealth programs. The telehealth programs will promote suicide awareness amongst teens and young adults by increasing access to the National Suicide Prevention Lifeline and Crisis Text Line. The bill requires colleges and universities to provide the contact information for the National Suicide Prevention Lifeline, Crisis Text Line, and a campus mental health center, if applicable, on student identification cards.
Women’s Health Protection Act of 2022 prohibits the government from making restrictions on the provision of and access to abortion services. The wording from the bill introduced is below:
Specifically, governments may not limit a provider’s ability to:
- prescribe certain drugs,
- offer abortion services via telemedicine, or
- immediately provide abortion services when the provider determines a delay risks the patient’s health.
Under the Telehealth Extension and Evaluation Act, Medicare will expand and provide telehealth coverage on specific services for two years after the COVID-19 public health emergency (PHE) ends. The introduced bill will allow Medicare telehealth coverage for certain audio-only services and critical access to hospitals to provide telebehavioral health services (along with any authorized practitioner). Furthermore, it allows one telehealth evaluation with video to be acceptable for prescribing Schedule II through V controlled substances. Bill HR 7573 requires a report from the Centers for Medicare & Medicaid Services (CMS) to provide an update on the impact of the changes made during the PHE period in terms of Medicare telehealth services.
Updated CCHP Semi-Annual State Telehealth Law Report
The Center for Connected Health Policy (CCHP) has released its Spring 2022 Summary Report of the state telehealth laws and associated Medicaid program policies. The information from the CCHP online tool can be exported for each state into a PDF document using the most current information available on CCHP’s website. The information for this summary state telehealth law report covers updates in policy made between January and mid-April 2022. See the report on the CCHP website.
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