The Consolidated Appropriations Act, 2022 extends flexible telehealth regulations adopted during the federal health emergency.
Before the COVID-19 pandemic, Medicare covered telehealth services only in underserved rural areas and only when delivered in approved medical facilities, not in a patient’s home. Public health programs and most private insurers required enrollees who sought mental health care remotely to have an in-person visit within six months.
The spending measure allows Medicare to continue reimbursing medical providers for expanded telehealth services for 151 days beyond the emergency, which is expected to end in July. In addition, employers can offer telehealth coverage to employees in high deductible plans until the end of the year. The omnibus bill was signed into law on March 15.
Extending telehealth flexibility for such a limited time is puzzling, says John C. Goodman, president of the Goodman Institute and co-publisher of Health Care News.
“Why would Congress extend our right to talk to our doctor by phone and video for only five months?” said Goodman. “Why is Congress even involved at all? Surely these are decisions patients and doctors can make on their own, without asking permission from Big Brother.”
More Telehealth, Less Spending
The temporary extension could be related to the belief telehealth would require additional funds for Medicare, says Charlie Katebi, a health policy analyst at Americans for Prosperity (AFP).
“But there is a lot of research already that shows this would not be increasing spending,” said Katebi. “You’re not adding new people to the rolls, you are simply allowing people to access services remotely.”
Within weeks of the emergency declaration, federal agencies suspended regulations on over 240 telehealth services. The number of telehealth patients rose 7,400 percent to 10.1 million in the first six months of 2020, according to a report by AFP and the Progressive Policy Institute. The report also looked at the rate of private-sector health care utilization: over time, telehealth consumers tended to use less health care, not more.
Telehealth use soared from March to April 2020, then stabilized two months later, according to a study by McKinsey & Company.
Extends Physicians’ Reach
Congress would have to pass separate legislation to remove telehealth restraints permanently, says Katebi.
“As the months go forward, we are going to see even more research on how telehealth saved money and reduced the need for expensive procedures,” said Katebi. “I think that research is going to be helpful as lawmakers think through why these reforms are so important.”
One obstacle could be resistance from providers who believe virtual visits could reduce the opportunity for selling more medical services; however, that thinking is changing, says Katebi.
“The reason why is because telehealth can be a revenue generator, said Katebi. “[Providers] can see and treat a lot more patients quickly, than have to wait for them to come in. With telehealth, you’re quickly in and out.”
AnneMarie Schieber (email@example.com) is the managing editor of Health Care News.
Charlie Katebi and Arielle Kane, “Telehealth Saves Money and Lives: Lessons From the COVID-19 Pandemic,” Americans for Prosperity, Progressive Policy Institute, December 2021: https://americansforprosperity.org/telehealth-expansion-improves-outcomes-and-lowers-costs-finds-new-bipartisan-report-from-ppi-and-afp/