Telehealth Reform: US Congress Heeds Public Outcry
Continued public outcry for telehealth reform has led to a remarkable display of bipartisanship, with representatives of the US House and Senate working on several efforts to support the permanent expansion of telehealth. Introduced in the House, the Advancing Telehealth Beyond COVID-19 Act, H.R.7338, would allow many telehealth regulations implemented through the CARES Act during the pandemic to remain permanent. For example, the proposed legislation will allow the HHS to waive geographical limitations for Medicare beneficiaries using telehealth or remote patient monitoring services; establish permanent telehealth coverage at Rural Health Clinics (RHC) and would advance telehealth access to emerging technology for seniors, especially in rural areas.
Several other key bills of interest to behavioral health professionals are briefly described below:
Mental and Behavioral Health Connectivity Act
U.S. Senators Angus King (I-Maine) and Todd Young (R-Ind.) recently introduced the Mental and Behavioral Health Connectivity Act, known as S. 3998, which would allow Medicare beneficiaries to extend telehealth access for mental and behavior health services. The Act is supported by the American Counseling Association, American Psychiatric Association, American Psychological Association, Mental Health for America, National Association of Social Workers, National Association of State Mental Health Program Directors, and the National Suicide Prevention Foundation.
If passed, the bill would permanently change a number of key pieces of legislation to:
- Allow Medicare beneficiaries to keep receiving care in their home
- Continue eligibility of care to the currently expanded list of non-physician providers, which allows for many types of professionals to be reimbursed for delivering Medicare services, and
- Allow Medicare to cover audio-only (telephone) delivery of telehealth services.
Telehealth Addiction Services: TREATS ACT
U.S. Senators Rob Portman (R-OH) and Sheldon Whitehouse (D-RI) introduced the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS Act) to address substance abuse. The bill has support from American Society for Addiction Medicine, American College of Medical Toxicology, Kennedy Forum, National Association of Addiction Treatment Providers, National Association of Behavioral Health, National Safety Council, Shatterproof, and Well Being Trust.
The argument is that existing temporary waivers on e-prescriptions are time-bound and will expire after the COVID-19 Public Health Emergency. The TREATS ACT aims to make permanent key waivers for e-prescribing such as the permission to prescribe Medication Assisted Therapies (MAT) and other essential drugs without requiring in-person visits. Of particular note is that the TREATS Act includes support for Medicare reimbursement for audio-only telehealth services (telephone). As pointed out by Portman, the bill is essential for augmenting addiction treatment, where no-show rates are high, even if access to care is offered.
Increased Broadband for Telehealth Reform
On another front in the fight for telehealth reform, Senate Bill 4201 or known as The Rural Broadband Acceleration Act, addresses access to broadband, the most significant structural barrier in making telehealth work for the underserved. The bill will boost efforts in making rural broadband more accessible across the country. If passed, rural America will have the same level of broadband service experienced by the cities and suburbs. Simultaneously, identical legislation was also introduced in the house of representatives by Fred Upton (R-MI) and House Majority Whip Jim Clyburn (D-SC). The authors of the bill have highlighted telehealth as one of the essential reasons for its legislation. “Millions of Americans still lack access to high-speed broadband, which means they don’t have access to online learning, teleworking, and telemedicine at the very moment they’re most needed during the COVID-19 pandemic,” said Senator Bennet. Senator Brown also commented on the self-protection aspects of strong internet connections, “The better your internet connection, the better you’re able to protect yourself – you need broadband to apply for unemployment, or to order groceries, or to have a telemedicine appointment.” House Majority Whip Clyburn, described the need for telehealth reform in South Carolina stating, “Telework, telemedicine, and distance learning are impossible without broadband access. Nearly 1 in 10 South Carolina households lack access to a reliable broadband connection.”
Other Legislative Action toward Telehealth Reform
As outlined in TBHI’s Telehealth Newsletter last week, legislative action is surfacing in a number of areas, particularly after the American Telemedicine Association, Alliance for Connected Care and NCQA spearheaded a task force to lobby Congress to keep the momentum going. They include:
- S. 3988 Amends the Public Health Service Act with respect to telehealth enhancements for emergency response. It supports the federal tracking, maintenance and improvement of the country’s ability to provide health care through telehealth systems.
- H.R. 7233 calls for federal officials to report to Congress on efforts to expand access to telehealth services, through Medicare, Medicaid and the Children’s Health Insurance Program, during the COVID-19 emergency.
What Can You Do to Support Telehealth Reform?
Not only have 340 healthcare organizations urged congress to legislate permanent telehealth reforms on four key issues, but the Taskforce on Telehealth Policy is seeking public input as it develops policy recommendations to advance quality and patient experience while establishing a stable, long-term environment that fosters the growth and integration of remote services within the healthcare system. The public comment period has been extended to Monday, July 13, 2020. You may also want to contact your state representatives to encourage their support of the many telehealth reform bills currently being introduced. Please post updates and new legislation below.
Deepening your own understanding of telehealth may also be warranted to assure compliance with published competencies. Courses offered at the Telebehavioral Health Institute include Telehealth Certifications, a 4-hour live, interactive COVID update and Telehealth Clinical Best Practices Workshop as well as a newly scheduled Minimizing Zoom Fatigue webinar.