Telehealth: Beyond COVID-19
President Trump on March 13th 2020 declared a national emergency due to the COVID-19 pandemic. Emergency authority was given to the Secretary of HHS to “temporarily waive or modify certain requirements of the Medicare, Medicaid, and State Children’s Health Insurance programs and of the Health Insurance Portability and Accountability Act Privacy Rule throughout the duration of the public health emergency declared in response to the COVID‑19 outbreak.”
Decisions based on this declaration came in a rapid-fire sequence. HIPAA enforcement was relaxed and telehealth reimbursement for many types of clinical encounters was brought to parity with face-to-face encounters. The adoption of telehealth technology was immediate and widespread.
Questions now arise: What comes after the emergency is declared over? What will be the status of telehealth? Will the modifications to reimbursement continue? What has been the value of telehealth? The introduction of legislation in Congress holds the promise that these questions are on track to be answered.
On July 17th, a bipartisan bill entitled “Protecting Access to Post-COVID–19 Telehealth Act of 2020” was introduced in Congress. A press release from the office of Rep. David Schweikert (AZ-06), Co-Chair of the Congressional Telehealth Caucus, stated the bill would “continue the expanded use of telehealth beyond the Coronavirus pandemic by eliminating restrictions on the use in Medicare, providing a bridge for patients currently using the practices because of the crisis, and requiring a study on the use of telehealth during COVID-19.”
The press release further states:
This bipartisan bill works to expand the use of telehealth after the end of the Coronavirus crisis by:
Eliminating most geographic and originating site restrictions on the use of telehealth in Medicare and establishing the patient’s home as an eligible distant site so patients can receive telehealth care at home and doctors can still be reimbursed,
Preventing a sudden loss of telehealth services for Medicare beneficiaries by authorizing the Centers for Medicare and Medicaid Service to continue reimbursement for telehealth for 90 days beyond the end of the public health emergency,
Making permanent the disaster waiver authority, enabling Health and Human Service to expand telehealth in Medicare during all future emergencies and disasters, and
Requiring a study on the use of telehealth during COVID, including its costs, uptake rates, measurable health outcomes, and racial and geographic disparities.
Other legislation has been introduced and is winding through the process. These bills attempt to map out an appropriate place for telehealth in healthcare delivery after COVID-19. A few notable examples are:
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
For telehealth, it is clear we are moving in the right direction to take advantage of Lessons Learned and Best Practices gained during the pandemic. What we see emerging is a telehealth foundation based on technology, appropriate use cases, and measured data. Beyond telehealth only for episodic care may be the real promise of remote patient care for the management of chronic disease. That may be the greatest outcome of all for this wave of telehealth adoption.