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Permanent Medicare Telehealth Expansion Gains Lawmaker Support

Posted on Wednesday, March 3, 2021
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by Outside Contributor
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Looser telehealth restrictions for Medicare beneficiaries enacted for the Covid-19 pandemic should be made permanent, the leaders of a key House health committee said.

The expansion of telehealth, where health-care providers treat patients using remote technology, over the past year has proven that many of Medicare’s tight restrictions on the service should end, Anna Eshoo (D-Calif.), head of the Energy and Commerce Committee’s health panel, said Tuesday. Telehealth can address matters such as specialist shortages by connecting patients with doctors remotely, she said.

“It’s time to make Medicare reimbursement for telehealth permanent,” she said.

Eshoo lauded two bills from the last Congress during a Tuesday hearing. One would have expanded use of the technology where there are doctor shortages and for emergency and mental health care. The other would have required a study on changes made to telehealth during the Covid-19 pandemic.

In 2020, the government temporarily approved Medicare to pay for telehealth outside rural areas and add more than 100 new telehealth-eligible services. The Centers for Medicare and Medicaid Services also allowed some health visits over the phone, waiving requirements for audio-visual technologies, and increased what it pays doctors for some telehealth visits to make them comparable to in-person visits.

As a result, Medicare beneficiaries used telehealth for 43.5% of their primary care visits in April compared to less than 1% in February, before the start of the pandemic, according to the Department of Health and Human Services.

Several prominent health organizations have urged Congress to make these changes permanent.

Geographic restrictions on the technology are “outdated” and should be eliminated, Jack Resneck, a board member with the American Medical Association, the country’s largest lobby for physicians, told the Energy and Commerce Committee.

Doctors will use telehealth technologies if insurers such as Medicare will pay them to see patients remotely, he said

“The successful adoption of telehealth throughout the country has demonstrated that, if the financial barriers are removed, physicians will adopt important innovations in the delivery of care that are necessary to improve their patients’ health,” Resneck said.

Frank Pallone (D-N.J.), chair of the House Energy and Commerce Committee, warned lawmakers to guard against fraud tied to telehealth expansion. He said he also wants to ensure the changes won’t leave out poorer communities that might be unable to access the technology needed for telehealth.

“We obviously want to make things permanent but we also have to be careful about how we do it,” Pallone said.

Mixed Results

The expansion of telehealth has had “mixed” results for Medicare beneficiaries, said Frederic Riccardi, president of the Medicare Rights Center, an advocacy organization. Some were able to reach their doctors more easily from the comfort of their own homes while others weren’t even offered the service or lacked the tools for it.

Relaxing Medicare restrictions around telehealth should be done gradually to give some beneficiaries who might struggle with the technology time to adapt, Riccardi said.

Cost is a major barrier for lawmakers to expanding telehealth in Medicare.

Studies have shown telehealth doesn’t generally replace in-person visits, meaning it would add costs to Medicare, Ateev Mehrotra, an associate professor at Harvard Medical School, told the panel.

Some lawmakers are worried Medicare already has a sustainability problem. A key funding mechanism for the public health insurance program for the elderly and disabled, the hospital insurance trust fund, will be insolvent in a few years, Rep. Cathy McMorris Rodgers (R-Wash.) said Tuesday.

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