The U.S. House of Representatives approved a bill to extend Medicare telehealth reimbursement until 2024, about two years longer than scheduled previously.
The omnibus spending package Congress approved in March granted pandemic reimbursement flexibilities for 151 days after the end of the public health emergency.
The expiration of the public health emergency, however, has been pushed back several times this year—first to April, then July, and now October 13.
Expansion Has Bipartisan Support
The House approved the Advancing Telehealth Beyond COVID-19 Act of 2021 (H.R. 4040) in a 416 to 12 vote, on July 27.
The bill allows Medicare beneficiaries to receive telehealth services from any location, including their home, and expands the types of medical professionals and facilities that can be reimbursed for telehealth. It also allows audio-only technology for behavioral health, substance use disorder services, and health care management and evaluation.
The bill will allow Medicare to reimburse telehealth services until December 2024. The bill is expected to be approved by the U.S. Senate and signed by President Joe Biden.
Waste, Fraud, Abuse Concerns
Congress should not extend telehealth reimbursement until its utilization is more fully understood, says Joshua Gordon, director of health policy at the Committee for a Responsible Federal Budget, a fiscal policy group.
“Telehealth will appropriately remain an important part of the health care system going forward,” said Gordon. “However, current law already allows for telehealth extensions 151 days beyond the end of the just extended public health emergency, and there is little need to rush into a broad two-year extension.”
Congress has not yet received the required reports on virtual medical services, says Gordon.
“Prior congressional legislation mandated multiple studies on telehealth utilization and costs, and on preventing waste, fraud, and abuse—all due within the next year,” said Gordon. “Legislators should wait for this information before blanket extension, especially given that coverage in Medicare would cost at least $25 billion over a decade, and likely more than that when looking at overall national health expenditures.”
Certain actions by regulators would be especially problematic, says Gordon.
“We are very concerned about reports that some are pushing Congress to extend current policy of exempting telehealth visits from deductibles for those in high-deductible plans tied to Health Savings Accounts,” said Gordon. “This creates perverse incentives that increase health care spending, drive higher utilization, unjustifiably advantaging telehealth over in-person care, and counteract the core purpose of high deductible health plans.”
-Staff reports
Internet info:
“Fiscal Considerations for the Future of Telehealth,” Committee for Responsible Federal Budget, April 21, 2022: https://www.crfb.org/papers/fiscal-considerations-future-telehealth