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Expect Telehealth Rule Changes to Stay in Place — At Least for a While

By March 30, 2022No Comments


by Joyce Frieden, Washington Editor, MedPage Today

— Congress already extended the changes for 5 months and likely will extend them again, expert says

Telehealth rules that have been loosened during the COVID-19 pandemic will likely be extended temporarily before any permanent changes are made, one expert said at a briefing sponsored by the Kaiser Family Foundation.

The public health emergency necessitated by the pandemic itself has been extended through mid-April. In addition, Congress has already extended the telehealth flexibilities for 151 days, or about 5 months, beyond that, explained Krista Drobac, executive director of the Alliance for Connected Care, a lobbying group for telehealth providers. That extension was needed to match up with a temporary increase in Medicaid reimbursement for U.S. territories, she said at the Tuesday event.

Congress also required the Medicare Payment Advisory Commission (MedPAC) and the Office of Inspector General (OIG) at the Department of Health and Human Services to report on how well the telehealth flexibilities are working, but those reports aren’t due until June 2023, Drobac said. “I do not believe that Congress will make permanent changes to the law without real analysis by MedPAC or OIG, so our expectation is that the next action … will be another extension. And then once those reports come out, and more peer-reviewed analysis comes out of what happened during the pandemic, then we’ll lobby on permanent changes.”

Telehealth flexibilities for the Medicare program that have been in place during the pandemic include:

  • Fewer restrictions on where telehealth could be provided — previously Medicare would only reimburse for telehealth services provided to rural beneficiaries, and the beneficiary had to go to a medical facility to receive the service; those rules were relaxed during the pandemic. As a result, in 2020, “we had 28 million [telehealth] visits by Medicare beneficiaries; that compares to less than 350,000 visits in 2019,” said Drobac.
  • More Medicare provider types were able to use telehealth, including speech therapists, occupational therapists, and physical therapists.
  • The Drug Enforcement Administration loosened its restrictions on medication prescribing via telehealth, including requiring an in-person visit prior to prescribing controlled substances — a change that affected mostly behavioral health patients, she said.
  • Medicare allowed audio-only telehealth to be reimbursed.

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