The draft released today would permanently lift geographic and originating site restrictions in Medicare.
Ways & Means Republicans Circulate Telehealth Discussion Draft
The draft released today would permanently lift geographic and originating site restrictions in Medicare.
It would also make permanent flexibilities related to eligible practitioners, telehealth media, face-to-face visits, and more.
The Committee has said that it would like to see permanent telehealth flexibilities in the next COVID-19 relief package.
Today, the Republicans of the House Ways & Means Committee issued a
discussion draft of a bill to make permanent several of the temporary telehealth flexibilities implemented in response to the COVID-19 pandemic (
press release). The draft bill represents the first public Congressional attempt to comprehensively make those flexibilities permanent. Ways & Means Republicans have expressed interest
in inserting this or similar legislation in an upcoming COVID-19 relief bill. As it is a Ways & Means bill, it primarily focuses on Medicare issues and the tax code. The Committee has expressed interest in feedback on the legislation and in help promoting the underlying policies.
Background. The provision of telehealth care has been long constrained by payment restrictions in the Medicare program. In COVID-19 legislation, Congress created the ability for HHS to waive restrictions related to beneficiary geography and originating sites during a public health emergency (PHE) as well as to permit payment to Rural Health Centers (RHC) and Federally Qualified Health Centers (FQHC) for telehealth services. HHS implemented those flexibilities and others that were already permitted, and they remain in effect contingent on the continuation of the emergency. Many stakeholders and policymakers have expressed interest in making those flexibilities, which have resulted in significant utilization of telehealth in the Medicare program, permanent.
Key provisions in the bill are described below:
Originating Site and Geographic Restrictions — The bill would remove the requirements that Medicare patients receiving telehealth services be located in a rural health professional shortage area or not be located in a metropolitan statistical area. It would also make beneficiaries’ homes acceptable originating sites in all circumstances.
FQHC and RHC Payment — The bill would permanently permit payment to FQHCs and RHCs for telehealth services. In response to the COVID-19 pandemic, Congress had temporarily permitted such payments.
Eligible Practitioners — The bill would permanently allow physical therapists, occupational therapists, and speech-language pathologists to receive Medicare payments for telehealth services. It would also permit the Secretary of Health and Human Services (HHS) to designate other practitioners to be eligible to provide telehealth services.
Audio-Only Telehealth — The bill would permanently allow for audio-only telehealth if a beneficiary does not have access to a communication system with audio-visual capabilities. The Committee has said that it is interested in feedback to ensure that there are appropriate guardrails on audio-only telehealth.
Face-to-Face Visits — The bill would remove the requirement for face-to-face visits between home dialysis patients and physicians, so long as the patient has received a mandatory in-person initial training. The bill would also permit the HHS Secretary to permit any face-to-face visit that is required for the provision of a service to be provided via telehealth, so long as it is determined to be appropriate by the Secretary.
Program Integrity — HHS would be required to submit a report to Congress on waste, fraud, and abuse associated with telehealth no later than a year after the end of the PHE. In addition, the bill would authorize $10 million for the review of telehealth claims.
Education — HHS would be directed to develop educational resources and training sessions on providing telehealth and make them available to practitioners using telehealth.
Telehealth Cost Sharing — The bill would make permanent a safe harbor that allows HSA-compatible health plans to cover telehealth services without regard to the deductible.
