The Acting Secretary for the U.S. Department of Health & Human Services (HHS) indicated in a recent letter to state Governors that the Department intends to extend the declaration of a Public Health Emergency (PHE) through at least the end of 2021. The Public Health Service Act grants HHS broad authority to issue a PHE declaration that remains active for a 90-day period. In 2020, HHS took a wait-and-see approach to reauthorizing the PHE declarations it issued in response to the COVID-19 pandemic. This meant reevaluating the PHE declaration based on the evolving situation and reauthorizing the PHE declaration near the end of each 90-day period. In addition, the Acting Secretary indicated in the letter that the Department will provide states a 60-day notice prior to the termination of the PHE declaration.
In the Acting Secretary’s own words, this shift is intended to bring “predictability and stability” to states and their public health programs, many of which have tied expiration of their telehealth expansions to the federal PHE declaration. The letter specifically highlights the flexibilities that the PHE declaration affords for the provision of telemedicine services to Medicaid and Medicare beneficiaries. For state Medicaid programs, this will also create some budget certainty with an extension of the Federal Medical Assistance Percentage (FMAP) rate increase set to expire at the end of the PHE.
Current Medicare telehealth flexibilities, such as the removal of the rural requirement and expansion of certain procedure codes and telephone visits, are all scheduled to sunset once the PHE declaration is rescinded. Medicare expanded additional Category 3 procedure codes in the 2021 Physician Fee Schedule that will sunset at the end of the calendar year in which the PHE declaration is terminated (see CCHP’s Physician Fee Schedule Fact Sheet for more information). Based on the Acting Secretary’s letter, this could mean that these flexibilities and expanded services will all sunset by the end of 2021 unless Congress passes legislation to codify them.
The announcement is also likely to have an impact on some private payer’s temporary telehealth policies. A recent Center for Connected Health Policy report titled, An Analysis of Private Payer Telehealth Coverage During the COVID-19 Pandemic, found that several of the largest national insurers that temporarily expanded their telehealth coverage or waived cost sharing for telehealth services tied their expiration to the federal PHE declaration. Under the Families First Coronavirus Response Act (FFCRA), private payers are also required to cover telehealth services that are associated with a COVID-related diagnosis through the end of the PHE.
For more information, view the full letter from the Acting Health & Human Services Secretary.