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When the CARES Act came into practice in March of last year, it brought changes to telehealth law, including the Center for Medicare and Medicaid Services (CMS) approach to telehealth reimbursement. This represented an updating of an approach that had largely been in place and unchanged since 1997.
How Telehealth Law Changes Have Been Perceived
As detailed by Telehealth.org in The Future of Telehealth, Teletherapy, and Telemedicine, these changes have largely been successful and met with enthusiasm by clients, patients, and practitioners. The latest Medicare Payment Advisory Committee report to Congress similarly reflects the effectiveness of these changes in telehealth law. According to their data, 2/3 of all clients and patients felt very satisfied with their telehealth experience. Expanding the term to “satisfied” results in 90% of all surveyed answering in agreement.
Confidence in using telehealth has also risen. This March, Sykes surveyed Americans about their feelings on telehealth and found people’s comfort with it as a healthcare delivery system has risen. Telehealth use also rose, with just over 61% of all respondents indicating they had received digital care since the passage of telehealth law changes. In contrast, before March of 2020, only 19.5% of respondents had done so.
A Return to Previous Telehealth Reimbursement
Therefore, CARES brought about arguably long-needed updates to telehealth reimbursement. Importantly, these changes have proven very popular with clients, patients, and practitioners. However, as Telehealth.org noted in 7 States Announce Changes to Telehealth Reimbursement Post-COVID and in Continuing Telehealth Regulations to Support Ongoing Telehealth Services, these temporary changes have already begun being rolled back in certain locations.
At the Federal level, just two weeks ago, the current provisions were extended for another 90 days. Without further intervention to lengthen them again or permanently adopt them, CARES’ changes will expire on October 18th.
What May Be Lost with A Regression in Telehealth Law
Chief amongst the changes that will go away without further extensions or establishing permanency is the geographic restrictions. Before CARES, practitioners like yourself who could serve via telehealth faced limitations by your and the client’s location. CARES lifted those restrictions, allowing clients in underserved areas to reach out across state lines and connect with practitioners in locations where services are easier to come by.
Also at contention is the Interim Final Rule. This rule allows telehealth sessions that utilize audio only to be treated as equivalent to audiovisual sessions. Before CARES, this exemption did not exist, leaving out people who came from areas with poor internet coverage or who lacked computer know-how. If CARES changes in telehealth law expire, this too will go away.
Finally, HIPAA restrictions loosened throughout the pandemic, in recognition of how quickly practitioners had to adapt to the changes in telehealth reimbursement. While most support a return to stronger HIPAA laws, an extension would allow practitioners to be better prepared for that eventuality.
A Hope for Changes in Telehealth Reimbursement Becoming Permanent
Some in Congress have been working on addressing telehealth reimbursement. The most prominent and promising of these possibilities comes in the form of the CONNECT for Health Act of 2021, proposed to the chamber by Senator Brian Schatz in late April of this year. At last count, it has been co-sponsored by a bipartisan collection of 49 other Senators.
The changes addressed above are mentioned within its provisions, including geographical restrictions for telehealth reimbursement, the larger range of services approved to utilize telehealth, and audio-only sessions to continue as an approved telehealth route. CMS is also contemplating crafting a Physician Fee Schedule (PFS) update that will extend several telehealth reimbursement changes as far as the end of 2023. Further, the proposed update includes a provision to study the viability of making the changes permanent if accepted.
A Call for Action
Telehealth.org joins with Kyle Zebley—the Vice President of Public Policy for the American Telemedicine Association—in encouraging all practitioners such as you to reach out to your elected officials and advocate for the passage of the CONNECT for Health Act and the permanency in changes to telehealth reimbursement it promises.
We at Telehealth.org have been encouraging our readers to submit such letters for months now. One letter will suffice. Clearly state your desire for them to shepherd or support CONNECT into law so clinicians can continue to use evidence-based technology to deliver 21st Century healthcare. Include a case example without identifying any patient or client to illustrate the good that changes in telehealth law have already brought about.
Telehealth.org urges all those interested in offering CMS comments, by September 17th, on their proposed PFS updates. While not as permanent as the CONNECT for Health Act, it nonetheless gives practitioners and advocates over a year to demonstrate the necessity of telehealth reimbursement.
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