CONNECTions for all: Expanding coverage for telemedicine beyond COVID

The COVID-19 pandemic has impacted health care workers, patients and the health care system in general in more ways than we ever thought possible. Although many of the impacts—such as overloaded hospitals and postponed procedures—were negative, some initiatives that began during COVID have impacted the delivery of patient care for the better.

Unprecedented access to care

The expansion of telemedicine, for instance, has provided unprecedented access to health care to those who may not otherwise have it. Telemedicine quickly advanced due to need with stay-at-home orders and concerns regarding availability of personal protective equipment (PPE) early in the pandemic.

For those who cannot leave their homes due to quarantine or illness, such as during the height of COVID-19 waves, telemedicine offered a cost-effective and easily accessible alternative to in-person care.  Outside of COVID-19, the same is true.

Patients who may not otherwise have transportation, who are immunocompromised, who may not have a specialist in their town and patients who struggle to access care for many other reasons now have this option for their health care needs.  

Certainly, telemedicine is not infallible. Concerns with health care delivery by this method include: lack of adequate broadband internet access for some hard-to-reach locations, appropriate coding and billing, adoption of coding and billing by private payors, HIPAA compliant interfaces, audio-only versus video and location of services.

Telemedicine expansion during COVID

In January 2020, the Secretary of Health and Human Services at the time declared a public health emergency (PHE) in relation to the escalation of the novel coronavirus. The PHE declaration provides the U.S. Department of Health and Human Services and federal agencies such as the Centers for Medicare & Medicaid Services (CMS) with expanded authority to take certain stabilizing action during the PHE.

However, any action taken under the PHE authorization ends with the expiration of the PHE. The PHE declaration lasts up to 90 days; it either has to be extended or automatically expires at the end of each 90-day period. The PHE was most recently extended in January 2022 and is now scheduled to expire in mid-April.

Early in the pandemic, CMS significantly expanded coverage for telehealth visits under the PHE, with other insurers following suit. However, without intervention, this expansion could be halted when the PHE is declared over. Fortunately, Congress just acted on this issue as part of an annual spending bill.

Recognizing that the PHE could end this summer, Congress included language that extends emergency telehealth provisions for 151 days following the end of the COVID-19 PHE, which would keep these telehealth policies in place at least through the end of the current calendar year. However, questions remain about what private insurers will do and what Congress will do to ensure continued access for patients and coverage for telehealth services after this year.  

Advocacy opportunities

Recently, the AOA joined several other partner organizations in a letter to congressional leaders to urge Congress to extend Medicare telehealth flexibilities for as long as two years following the declaration of the end of the PHE.

The AOA has also advocated that the Senate Committee on Finance take up two pieces of legislation that would improve telemedicine services and extend coverage for beneficiaries and the reimbursement process beyond the PHE of the COVID-19 pandemic.

The Telehealth Modernization Act would extend certain flexibilities that were initially authorized during the COVID-19 PHE, including allowing rural health clinics and federally qualified health centers to serve as the distant site and would also allow a patient’s location to serve as the originating site for all services. 

The AOA has also been advocating for the CONNECT for Health Act, (H.R 2903/S. 1512), which would address barriers to telehealth access by allowing the Secretary of Health and Human Services to waive certain restrictions (geographic, originating site, modality limitation, provider type and service requirements), and expanding coverage on a permanent basis, increasing the support of these service modalities that physicians and patients have come to rely on this delivery system.

The CONNECT Act will be one of the issues that DO Day participants will be advocating for in their Congressional meetings on April 27. Learn more about attending DO Day here.

For people not attending DO Day this year, your engagement on this issue can also have an impact. By using the AOA’s Advocacy Action Center, you can email your members of Congress and urge them to cosponsor the CONNECT for Health Act (S. 1512/H.R. 2903). 

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