Guidelines for Telehealth Rules and Policies
As telehealth has become more readily available during the coronavirus crisis, many people have come to view telehealth as the new norm. However, once the crisis has passed, telehealth will have to be reevaluated. Over the past couple of weeks, CMS and Congress have received several requests to expand telehealth availability permanently. Telehealth rules and policies are discussed below.
Determining Telehealth Rules and Policies
Although the Centers for Medicare & Medicaid Services (CMS) has made their willingness to review their telehealth rules and policies known, Congress will need to pass new laws to make telehealth expansion possible.
In a letter to Congressional leadership, 29 Senators asked for emergency telehealth provisions to be permanent. The letter from June 15, 2020 states, “ Americans have benefited significantly from this expansion of telehealth and have come to rely on its availability. Congress should expand access to telehealth services on a permanent basis so that telehealth remains an option for all Medicare beneficiaries both now and after the pandemic. Doing so would assure patients that their care will not be interrupted when the pandemic ends. It would also provide certainty to health care providers that the costs to prepare for and use telehealth would be a sound long-term investment.”
One major criticism of the telehealth rules and policies from before the pandemic is that CMS telehealth reimbursement was based on a patient’s geographic location. Supporters of extended telehealth availability argue that all Medicare beneficiaries should have equal access to telehealth services.
In addition to the letter sent by Senators to Congress, the American Telemedicine Association (ATA) sent a letter in May, 2020. Within the letter, ATA made nine recommendations for telehealth rules and policies:
- Expand the Federal Communications Commission’s $200 million COVID-19 Telehealth Program to include for-profit hospitals and health systems and others not included in the pool, and add another $300 million to the pot.
- Expand the FCC’s Health Care Connect Fund Program to include public, non-profit entities.
- Increase funding for the Health and Human Services Department’s Public Health and Social Services Emergency Fund.
- Provide a payroll tax credit for COVID-19 hospital facility expenditures, which often include the purchase of telemedicine equipment and additional telehealth training.
- Amend Medicare Part B cost sharing to increase flexibility for telehealth use.
- Have HHS forge an agreement with at least one eligible organization to collect, analyze and report on telehealth, digital health and remote patient monitoring metrics. That group should partner with stakeholders to analyze utilization, cost, access, experience data and identified structural and policy barriers to care.
- Incorporate telehealth and RPM platforms into the National Health Security Strategy.
- Prioritize telehealth policy and elevate the Office for the Advancement of Telehealth, which is currently categorized under the Office of Rural Health Policy in the Health Resources and Services Administration.
- Address outdated 1834(m) restrictions on telehealth, perhaps by enacting the CONNECT Act for Health (S.2741 and HR.4932).