The Need to Make Telehealth Flexibilities Permanent

Amy Niles

Millions of people enrolled in Medicare have benefited from the telehealth flexibilities that were granted during the COVID-19 pandemic, and, subsequently, extended in 2022. However, without Congressional action, these flexibilities will end on Dec. 31, 2024—impacting access and leading to further health inequities.

Demand for telehealth services

Telehealth flexibilities have played a critical role in expanding access to care and maintaining continuity of care, especially those living in rural communities and underserved areas. For individuals requiring access to advanced specialists, mental health providers, and those with mobility issues or lack of transportation, telehealth flexibilities have served as a much-needed lifeline to care.

According to a national poll conducted by the PAN Foundation’s Center for Patient Research,¹ nearly one-third of adults who use telehealth services say they do so to refill their prescriptions (30%), to address less serious health issues (28%), and for mental health support (28%). Clinicians have used telehealth to expand access to care for patients and to support strong patient relationships, and they value the flexibility created by the option for remote care when clinically appropriate. Important safety-net providers such as community health centers and rural health clinics have depended on these flexibilities, as have clinicians such as physical, speech, and occupational therapists to extend access to patients.

How Congress can act

Over the past couple of years, several bills to permanently extend telehealth flexibilities for people enrolled in Medicare have been introduced with bipartisan support. This includes the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 (H.R. 4189), introduced by Rep. Mike Thompson (D-CA). While there are similarities between various telehealth bills, it is important that a final telehealth bill that is passed and permanently extends flexibilities includes the following:

• Expands patient access to telehealth services by removing geographic and originating site limitations to enable patients to communicate remotely with their providers, regardless of location.
• Removes distant site provider list restrictions to allow all Medicare providers who deliver telehealth-appropriate. services to provide those through telehealth. Providers would include physical and occupational therapists, speech-language pathologists, and social workers.
• Ensures that federally qualified health centers, critical access hospitals, and rural health clinics can furnish telehealth in Medicare and be reimbursed fairly for those services.
• Removes in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology.
• Allows the Centers for Medicare & Medicaid Services to cover audio-only telehealth services where necessary to bridge gaps in access to care. Audio-only telehealth visits should continue to be an option for patients who lack access to the resources needed to participate in video-based telehealth.
• Allows employers to offer telehealth benefits for seasonal and part-time workers. Increasing access to some telehealth benefits for part-time employees, seasonal workers, interns, new employees in a waiting period can be a meaningful way to support workers—as long as this access supplements health insurance purchased by that individual or a family member.
• Drives better and more coordinated care for those with chronic disease by ensuring adequate reimbursement for remote patient monitoring technology.

Since the pandemic, patient and provider groups have advocated for legislation that recognizes the value of telehealth services for Medicare beneficiaries. Congress must not wait until the end of the year to pass legislation that already has bipartisan support. We at PAN urge Congress to act now² to pass telehealth legislation that will positively impact millions of people in the US and their healthcare journeys.

About the Author

Amy Niles is chief mission officer at PAN Foundation.

References

1. Nearly Half of Adults Who Use Telehealth Face Barriers to Accessing Services. PAN Foundation. April 17, 2024. https://www.panfoundation.org/nearly-half-of-adults-who-use-telehealth-face-barriers-to-accessing-services/

2. Urge Congress to Expand Telehealth Flexibilities Before it’s too Late! PAN Foundation. https://www.votervoice.net/PANFoundation/Campaigns/114714/Respond