On May 8, the U.S. House of Representatives Ways and Means Committee unanimously passed a bipartisan bill entitled the “Preserving Telehealth, Hospital, and Ambulance Access Act.”
This bill aims to extend several telehealth flexibilities, including removing geographic restrictions from beneficiaries, expanding originating sites, and allowing clinicians such as occupational therapists and speech-language pathologists to provide services via telehealth. It also seeks to expand audio-only telehealth coverage, reduce in-person requirements for mental health service coverage, and enhance support for individuals with limited English proficiency.
The bill reflects an important continuation of bipartisan support since the rapid increase of telemedicine in 2020.
At the beginning of the COVID-19 pandemic, healthcare systems across the U.S. had quickly grown to rely on telemedicine consultation. Due to medical practice closure, risk of COVID-19 exposure, and financial instability, over 40 percent of individuals surveyed reported skipping medical care in early months of the pandemic.
For individuals with Alzheimer’s disease and related dementias (ADRDs), current studies show a significant increase in follow-up loss among patients newly diagnosed with dementia.
Telemedicine has become an essential offering, especially as its usage among physicians jumped from 15.4 percent in 2019 to 86.5 percent in 2021. At Penn Memory Center, all clinicians were reliant on this service.
There are several benefits to telemedicine for individuals with ADRDs.
Telemedicine allows greater access to specialist care. Many older adults benefit from remote care as they have limited mobility, live in rural areas, and/or don’t have proper transportation to access a clinic. Telemedicine also can reduce caregiver burden and stress. Notably, new studies suggest that telemedicine reduces emergency department visits, which could reduce cost of dementia care.
Technology integration may also increase with use of telehealth services. For example, many clinicians are including smart home technology to monitor progression of patient symptoms remotely.
In a 2022 article published by The Hill, Penn Memory Center Co-Director and physician Jason Karlawish, MD, stated, “This vision of telehealth is a great experiment whose costs, quality and equity must be evaluated. But if it succeeds, it will launch a revolution in health care that could benefit all Americans.”
The bill’s extended coverage is built upon foundational changes made during the pandemic.
To accommodate the rapid expansion of telemedicine, the Centers for Medicare and Medicaid Services relaxed telehealth restrictions and allowed clinicians to practice across state lines through the CMS 1135 Waiver. Coverage for telehealth services was expanded, out-of-state licensing requirements were waived, and the Coronavirus Aid, Relief, and Economic Security (CARES) Act provided an initial $200 million towards telehealth programming.
While the public health emergency ended on May 11, 2023, government support resounded from both political parties.
For example, prior to the pandemic, only 10 state laws required payers to reimburse telehealth services at the same rate (payment parity) as in-person care. By January 2024, 43 states passed laws implementing payment parity.
In 2022, the House of Representatives passed the “Advancing Telehealth Beyond Covid-19 Act of 2022,” which extended Medicare coverage through December 31, 2024.
With the latest bill, now going to the house floor, furthering this through 2026, clinicians like Dr. Karlawish are optimistic about the transformation of services offered.
To read Dr. Karlawish’s full Hill article, please click here.
To learn more about the May 8 bill, please click here.