The Telehealth Extension and Evaluation Act was introduced on February 7, 2022, to ensure a continuation of public access to telehealth after the end of a public health emergency. If passed, it will allow time to gather data concerning virtual care utilization and prevent a sudden drop-off in access to care, also known as the telehealth cliff.
What is the Telehealth Extension and Evaluation Act?
The Telehealth Extension and Evaluation Act establishes a two-year extension for certain coronavirus-related telehealth waivers. It will extend geographic and site restrictions waivers and allow Medicare beneficiaries to access telehealth from various locations. It also provides flexibility for prescribing drugs via telehealth and extends flexible Medicare payment plans for Rural Health Centers (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs).
The bill follows an advocacy letter signed by 336 organizations, co-led by the American Telemedicine Association (ATA) and others, urging Congressional leaders to continue the current telehealth waivers and pass permanent, evidence-based telehealth legislation for implementation in 2024.
Key Takeaways for the Telehealth Industry
The telehealth industry should be aware of the critical points of the Telehealth Extension and Evaluation Act.
- Extension of Medicare Payment for Telehealth Services. The CARES ACT allowed the Centers for Medicare and Medicaid Services (CMS) to waive specific Medicare coverage and payment limitations, allowing Medicare beneficiaries to receive telehealth care at home. If the Telehealth Extension and Evaluation passes, it will extend certain telehealth coverage waivers on originating site and geographic location limitations, expand the list of telehealth providers, and increase the availability of audio-only telehealth services to Medicare beneficiaries for two years after the public health emergency ends.
- Telemedicine Drug Prescribing. The Ryan Haight Act prohibits the prescribing of medicine without an in-person visit. Federal law allowed DEA registered practitioners to prescribe to patients without in-person visits during the pandemic. See TBHI’s previous article Telehealth Opioids, and Ryan Haight Act Update, for more information. The proposed legislation would extend this flexibility two years after the public health emergency.
- Extension of FQHCs and RHCs. Before the pandemic, Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) could only provide telehealth services to patients near their locations. The CARES Act allowed these facilities to provide care to patients in distant areas, a practice the legislation would continue for two years after the public health emergency expires.
- Extension for CAHs. The 2020 Hospitals Without Walls program allowed hospitals to provide telehealth care during a public health emergency. The proposed legislation would add Critical Access Hospitals (CAHs) as distant site providers of telehealth services to continue offering off-site care.
- Restrictions for Certain DMEs and Lab Tests. The legislation would require an ordering physician to conduct an in-person examination of a patient no more than 12 months before ordering specific high-cost lab tests and Durable Medical Equipment (DME) products via telehealth. It would also instruct Medicare Administrative Contractors to audit practitioners and clinicians who do 90% or more of their orders of DME and lab tests via telehealth. This would continue for two years after the health emergency ends. It is meant to reduce instances of fraud and abuse.
- NPI Number for Telehealth Billing. Healthcare providers need a national provider identifier (NPI) number to bill Medicare directly. Under certain conditions, Medicare pays for services billed by physicians but performed by non-physician staff acting under the physician’s supervision. This practice is known as “incident to” billing. The proposed legislation requires all practitioners to obtain an NPI number to receive Medicare payment for telehealth services two years after the public health emergency.
Your Advocacy Is Needed
The pandemic has caused an increased reliance on the telehealth industry. If passed, the Telehealth Extension and Evaluation Act will ensure that patients can continue to access the virtual care they need. Contact your elected officials at the federal level to ask them to support this crucial bill.
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