A bipartisan group of 38 senators released an open letter on Friday, asking U.S. Secretary of Health and Human Services Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma to provide a written plan for permanent changes to Medicare, Medicaid and Children’s Health Insurance Program rules around telehealth.  

"We are hearing from patients and providers who are concerned about when Medicare’s temporary changes to telehealth rules will be rolled back and whether they will receive any advance notice," wrote the senators, led by Sens. Tina Smith, D-Minn., and Bill Cassidy, R-La.  

"Patients are anxious about when private payers will change rates for telehealth services and if they will decide to rescind telehealth coverage altogether," they said.  

WHY IT MATTERS

The relaxation of many regulations from HHS has helped to ease the way toward a massive telehealth expansion amid COVID-19.   

"Due to the combined effect of Congressional and administrative actions, health care providers and patients can now deliver and receive telehealth services in their own homes," read the letter. "Patients and providers can use audio-only telephone telehealth to get care, and they don’t face the same limits on the number of services they can receive via telehealth."       

But as the senators note, that progress has been tinged with uncertainty about which of those regulation changes, if any, will be made permanent.   

In the letter, the group of senators explained that any written plan outlining permanent changes should include "sufficient public notice and comment periods in order to ensure that these permanent changes are not at the expense of access for patients in rural or underserved communities, patient privacy, protections against fraud, waste, and abuse, or quality of patient care."

The senators also asked for a written plan regarding OCR's enforcement discretion of HIPAA compliance – and a security analysis of non-HIPAA-compliant tools that providers and patients relied on during the pandemic.  

In addition, they asked Verma and Azar: to explain whether extending Medicare reimbursement parity to telehealth services provided by Federally Qualified Health Centers and Rural Health Clinics for the rest of the crisis would require congressional action; to release guidance for private health plans regarding future changes to telehealth coverage; and to outline the list of permanent health changes that can be made without congressional intercession.  

"We appreciate your recognition that, due to the COVID-19 pandemic, more patients and providers see the value of telehealth. We believe telehealth is an important tool that enhances patient care and can provide efficiency in health care delivery. While telehealth may not be able to replace all in-person care, we believe it should continue to be an option to meet individual care needs," wrote the senators.  

THE LARGER TREND

Smith and Cassidy have been at the forefront of several conversations regarding healthcare during the coronavirus pandemic.   

Smith told Healthcare IT News last month that in her view, expanding reimbursement for phone-based telehealth along with video was "the most important thing I think we could do." She drew particular attention to the needs of underserved communities, who may not have access to broadband.   

"We need to look at the layers of regulatory hurdles put in place to make it more difficult to use telehealth," she said. "We have to learn from our experiences and see what's worked and what we need to do better."  

Along with Cassidy – who also spoke to Healthcare IT News last month, regarding patient privacy and contact tracing – Smith in June introduced the Enhancing Preparedness Through Telehealth Act, aiming to "understand what the administration is doing right now, and what they can do without needing additional legislative authority."

The senators' open letter follows a request from hundreds of healthcare industry stakeholders to congressional leaders earlier this week to advance permanent telehealth changes.  

ON THE RECORD

"We encourage the Administration to consider how permanent changes to telehealth policy can be part of broader movement, including a shift toward value-based care. We look forward to your response and urge you to continue working with Congress to expand access to telehealth during the duration of the COVID-19 pandemic and after we put the pandemic behind us," wrote the senators.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Healthcare IT News is a HIMSS Media publication.