Calls for many telehealth waivers implemented for the public health emergency to stay in place
March 19, 2021 (ACP) – Telehealth came of age during the COVID-19 public health emergency, and it is here to stay. The American College of Physicians is helping to define and shape what this type of care will look like in the future and how it should be reimbursed.
“We recognize that telehealth isn't going away and will be an important element of care going forward,” said Brooke Rockwern, ACP senior associate of health IT policy. “It should be implemented in a way that supports our prime goal of providing patient-centered, high-value care and not furthering any health disparities.”
Many obstacles to telehealth were removed during the COVID-19 pandemic to help clinicians treat patients during widespread shutdowns. Now the conversation has shifted toward which changes should remain in place once the public health emergency is officially over, Rockwern said.
The federal government issued waivers that lifted geographical site restrictions to allow telehealth services to be delivered at any health care facility, in homes and outside of rural areas during the public health emergency. ACP is in favor of keeping these waivers in place permanently, Rockwern said. “Before the pandemic, patients could only receive telehealth services if they lived in rural, underserved areas, and we have always thought that this is a huge barrier to expansion, as even urban areas have issues with access to care,” she said.
In addition, waivers that allow doctors to reduce or eliminate cost-sharing for telehealth and audio-only telephone visits should be extended, and doctors should be compensated for the difference between these waived copays and the Medicare-allowed fee for the service, ACP wrote in a statement to the House Energy and Commerce Subcommittee. This extension should last at least through the end of 2021, with an option to extend it even further based on the experience of patients and physicians who are utilizing these visits, ACP noted in comments on the Centers for Medicare and Medicaid Services (CMS) final Fee Schedule for 2021.
Pay parity for audio-only and telehealth services – a huge advocacy win for ACP in 2020 – should also be kept in place for the immediate future, Rockwern said. “We need more data on the value of telehealth care to see what the best approach is moving forward as far as payment and reimbursement,” she said.
CMS implemented a temporary waiver allowing physicians to provide telehealth services across state lines as long as they meet specific licensure requirements and conditions, and this waiver should also be kept in place, Rockwern said. Moreover, ACP is calling for Congress or CMS to extend the interim policy to allow remote patient monitoring services for patients without an established relationship.
The good news is that the majority of these waivers and flexibilities are tied to the public health emergency status, and the Biden administration is planning to maintain this status for the time being, Rockwern said.
ACP offers up-to-date information on telehealth policy on the Practice Resources section of its website.