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New Telehealth Legislation Seeks to Expand Medicare Coverage

Analysis  |  By Mandy Roth  
   October 31, 2019

Removing geographic barriers and improving rural access are among the goals of CONNECT for Health Act of 2019, which has bipartisan Senate and House support.

Support for telehealth is breaking political barriers in the nation's Capitol. In a bipartisan, bicameral initiative, legislation to expand telehealth services through Medicare was introduced yesterday, led by U.S. Sen. Brian Schatz (D-Hawaii), with a companion bill presented to the House of Representatives.

Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 aims to improve health outcomes, make it easier for patients to connect with their doctors, and help cut costs for patients and providers, according to a news release issued by Schatz's office.

The bill includes provisions to remove geographic and originating site restrictions for services like mental health and emergency medical care, enhance the ability of rural health clinics and other community-based healthcare centers to provide telehealth services, and provide the secretary of Health and Human Services with the authority to waive telehealth restrictions when necessary. It also requires a study to explore ways to expand telehealth services to enable more people to access healthcare services in their homes.

The legislation is supported by more than 100 organizations including the American Hospital Association, the American Medical Association, and the ATA (American Telemedicine Association).

If the name of the bill sounds familiar, that's because it's an echo from the past. The CONNECT for Health Act was first introduced in 2016 by Schatz and the Senate telehealth working group. Since then, a number of its provisions have been signed into law or adopted by the Centers for Medicare & Medicaid Services, according to the release. The 2019 version includes new key measures that healthcare "experts, providers, and patient advocates agree will help improve access to care and drive down costs," the release says.

“Telehealth is the future of health care. The technology is advancing, more providers and patients are relying on it, and we have broad bipartisan support,” says Schatz. “This bill will help ensure that every American gets the care they need no matter where they live.”

In a letter to Congress issued in support of the legislation, the American Hospital Association said, “Currently, 76% of U.S. hospitals connect with patients and consulting practitioners at a distance through the use of live voice and video and other supporting technologies. Yet, systemic barriers to widespread adoption of telehealth in the Medicare program remain." The bill proposes changes that would allow for increased access to telehealth services for patients and remove barriers to adoption and use by hospitals and other providers, according to AHA.

Support for telehealth has been building in recent years due to its potential to lower costs and provide more convenient service to patients regardless of where they are located—objectives reflected in the mission of the industry association, ATA.

“The ATA is committed to ensuring that everyone has access to safe, affordable and effective care when and where they need it," said ATA CEO Ann Mond Johnson in a statement. "We believe that the ability to obtain care remotely is the key to achieving this vision, and the introduction of today’s legislation is an important step to achieving this shared goal."

Progress related to reimbursement remains a sticking point for many in the industry, however. The legislation introduced yesterday will not remove all of these barriers. A statement issued to HealthLeaders by Boston-based telehealth service provider American Well captures the broader concern:

"The CONNECT for Health Act marks positive momentum toward the advancement of telehealth," says Roy Schoenberg, MD, MPH, president and CEO of American Well. However, "until there’s broad government reimbursement support, we believe telehealth will be held back in becoming truly core to integrated care delivery models across a broad range of care scenarios."

Other senators joining Schatz in introducing the bill include Roger Wicker (R-Mississippi), Ben Cardin (D-Maryland), John Thune (R-South Dakota), Mark Warner (D-Virginia), and Cindy Hyde-Smith (R-Mississippi). Companion legislation was introduced in the House of Representatives by U.S. Representatives Mike Thompson (D-California), Peter Welch (D-Vermont), David Schweikert (R-Arizona), and Bill Johnson (R-Ohio).

Mandy Roth is the innovations editor at HealthLeaders.

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