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MedPAC recommends the continuation of telehealth for a limited time

During a study period, Medicare should pay for specified telehealth services regardless of a provider's location, MedPAC says.

Susan Morse, Managing Editor

Policymakers should temporarily continue some of the telehealth flexibilities allowed during the public health emergency for a limited time to gather more evidence about the impact of telehealth on care access, quality and program spending, the Medicare Payment Advisory Commission said in its report to Congress, released Monday.

In its policy option proposal, MedPAC gave one or two years after the end of the public health emergency to determine telehealth's impact.

During the one or two years of evidence gathering, Medicare should temporarily pay for specified telehealth services regardless of a provider's location, and the Centers for Medicare and Medicaid Services should continue to cover newly-covered telehealth services and some audio-only telehealth care, MedPAC said.

After the public health emergency ends, Medicare should return to paying the physician fee schedule facility rate for telehealth services, and collect data on the cost of providing these services, MedPAC said. 

Commissioners also advised CMS to implement safeguards to protect against unnecessary spending and potential fraud related to telehealth.

WHY THIS MATTERS

Since the onset of the COVID-19 pandemic, CMS has expanded coverage and reimbursement for telehealth services.

But these new waiver flexibilities, which gave providers payment parity for telehealth care, have been temporary. Without legislative action, many of the flexibilities which have allowed hospitals, physicians and other providers to adopt and expand telehealth for medical care, will end with the public health emergency.

Because of this, while use of telehealth exploded during the pandemic, hospitals and physicians may be reluctant to make significant investments in telehealth. The end of the PHE could spell a reduction in the use of telehealth.

The PHE has been extended until April 20.

MedPAC's report to Congress could spur greater legislative action.

THE LARGER TREND

In December 2020, then CMS Administrator Seema Verma said Congressional action was needed to keep telehealth from reverting to a rural benefit.

That same month, CMS issued the 2021 Medicare physician fee schedule final rule and interim final rule, which clarified which telehealth services would be covered by Medicare on a permanent or temporary basis. 

During the public health emergency, CMS:

  • lifted the geographic restriction that beneficiaries must be located in a rural area; permitted beneficiaries to receive telehealth services from their homes.
  • allowed a broader range of providers to deliver telehealth services, such as physical therapists, occupational therapists and speech-language pathologists.
  • added coverage and payment for audio-only forms of telehealth.
  • enabled rural health centers to serve as eligible distant sites.
  • expanded Medicare telehealth coverage to more than 100 additional services.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com