Sustainable Telehealth: Legislation

By Jim Tate, EMR Advocate
Twitter: @jimtate, eMail:
Host of The Tate Chronicles#TateDispatches

On August 3, 2020 President Trump issued an Executive Order entitled “Improving Rural Health and Telehealth Access”. This Order contained statements that demonstrate a commitment to make permanent a significant number of the temporary measures that promoted the widespread acceptance and adoption of telehealth services during the Public Health Emergency (PHE). The Executive Order reads in part:

During the COVID-19 public health emergency (PHE), hospitals curtailed elective medical procedures and access to in-person clinical care was limited. To help patient’s better access healthcare providers, my Administration implemented new flexibility regarding what services may be provided via telehealth, who may provide them, and in what circumstances, and the use of telehealth increased dramatically across the Nation.

Additionally, a recent report by HHS shows that nearly half (43.5 percent) of Medicare fee-for-service primary care visits were provided through telehealth in April, compared with far less than one percent (0.1 percent) in February before the PHE. Importantly, the report finds that telehealth visits continued to be frequent even after in-person primary care visits resumed in May, indicating that the expansion of telehealth services is likely to be a more permanent feature of the healthcare delivery system.

It is the purpose of this order to increase access to, improve the quality of, and improve the financial economics of rural healthcare, including by increasing access to high-quality care through telehealth.

Within 60 days of the date of this order, the Secretary shall review the following temporary measures put in place during the PHE, and shall propose a regulation to extend these measures, as appropriate, beyond the duration of the PHE: (a) the additional telehealth services offered to Medicare beneficiaries; and (b) the services, reporting, staffing, and supervision flexibilities offered to Medicare providers in rural areas.

There has been much discussion and “reading of the tea leaves” as to what would happen to telehealth after the COVID-19 pandemic passed. We are now seeing with clarity that telehealth benefits have been duly recognized and the technology is being embraced as a viable and significant channel for healthcare delivery. Best practices and appropriate use cases will continue to be worked out in the months and years to come, but it is clear that telehealth is no longer the forgotten step-child it was before COVID-19 thrust its capabilities directly into the mainstream of healthcare.

The Executive Order is not the only indicator that the value of telehealth is now seen at the highest levels of the federal government. A flood of legislation has recently been introduced in Congress to identify the value of telehealth as a valid component of healthcare delivery. Below is a partial list of bills introduced in this regard:

  • The Protecting Access to Post-COVID-19 Telehealth Act
  • Advancing Telehealth Beyond COVID-19 Act of 2020
  • KEEP Telehealth Options Act of 2020
  • Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act of 2020
  • The VA Telehealth Expansion Act
  • Telehealth Modernization Act
  • COVID-19 Telehealth Program Extension Act
  • The COVID-19 Emergency Telehealth Impact Reporting Act of 2020
  • The Telehealth Expansion Act of 2020
  • The Advancing Telehealth Beyond COVID-19 Act
  • Protecting Access to Post-COVID-19 Telehealth Act
  • The Equal Access to Care Act
  • The Helping to Ensure Access to Local Telehealth (HEALTH) Act of 2020

Initiatives in numerous states and by insurance entities are currently underway preparing the way forward to take advantage of telehealth’s value unearthed by the COVID-19 crisis. Legislation is moving forward to gather the data needed to identify best use cases and provide justification for appropriate reimbursement. It is clear that the technology is finding its rightful and permanent home in front-line healthcare delivery.

This article was originally published on Medivisum and is republished here with permission.