C-TAC has been a staunch supporter of the use of telehealth, particularly during the pandemic, when laws were passed that provided for temporary coverage of telehealth under Medicare.
C-TAC currently supports making certain serious illness-related telehealth care permanent, including Medicare hospice recertification, advance care planning (ACP) using telehealth and audio only. At least a two-year extension of most telehealth use is likely as it is currently a major topic of discussion on Capitol Hill. The House Ways and Means Committee is preparing to mark up a two-year extension of Medicare telehealth rules implemented during the COVID-19 pandemic. This would mark the first significant telehealth markup of this Congress. These rules are set to expire at the end of this calendar year, adding urgency to the discussions. The Committee did approve H.R. 1843 last June to allow high-deductible plans to permanently cover telehealth before customers hit their deductibles.
Prior to the pandemic, Medicare’s telehealth coverage was limited to certain rural areas, which required patients to travel to eligible health care facilities to access telehealth services. The current rules allow older Americans to have telehealth visits from the convenience of their homes rather than having to drive to a clinic, which can often be burdensome.
Pending bills like the CONNECT for Health Act (H.R. 4189), sponsored by Ways and Means member Mike Thompson (D-CA), and the Telehealth Modernization Act, sponsored by Rep. Buddy Carter (R-GA), seek to make the pandemic-era rules permanent. The proposed pieces of legislation include provisions for telehealth use in hospice care recertification and conducting face-to-face encounters in addition to allowing the use of audio-only telecommunications technology where clinically appropriate.
While telehealth advocates support an extension, there is a growing desire to make these rules permanent. However, key questions remain regarding reimbursement rates for virtual care compared to traditional in-person care and the potential impact on Medicare spending. Lawmakers, while generally supportive of telehealth expansion, are cautious about its cost implications and await the Congressional Budget Office’s cost score of an extension. Before a final deal moves forward, there will be continued discussions about the cost and value of telehealth, the potential for fraud, waste, and abuse, and how consumers will be helped or hurt in the long run, with the possibility that in-person care may become more difficult to find. On April 10, the Energy & Commerce Committee also held a hearing on these issues.
The Senate side has been discussing telehealth, as well, with action possible in the Finance Committee. Senator Brian Schatz (D-HI) is the lead on the CONNECT for Health Act in the Senate and has garnered 65 cosponsors for S.2016. Other legislation would allow employers to provide telehealth services as a tax-free benefit.
C-TAC will continue to work toward securing telehealth provisions that benefit individuals with serious illness and legislation with appropriate consumer protections.
