Kelly introduces legislation extending, expanding telehealth coverage

Washington, D.C. – Today, U.S. Rep. Mike Kelly (R-PA), joined by Ways & Means Health Subcommittee Chair Lloyd Doggett (D-TX), Ranking Member Devin Nunes (R-CA) and Health Subcommittee members Mike Thompson (D-CA), and David Schweikert (R-AZ), introduced the Telehealth Extension Act.

This bipartisan bill ensures permanent access to telehealth for patients across the country by ending outdated geographic and site restrictions on where patients can receive approved telehealth services. Following recommendations from the nonpartisan, independent advisory group Medicare Payment Advisory Commission (MedPAC), the bill also temporarily extends emergency authorities established during the COVID-19 pandemic that authorize a wide range of providers and services via telehealth. The temporary extension of these authorities will prevent an abrupt cliff in services at the end of the Public Health Emergency (PHE) period and allow for further study of the utilization and impact of telehealth in different medical settings.

Finally, to ensure Medicare program integrity, the Telehealth Extension Act implements MedPAC recommendations to prevent unnecessary spending and telehealth-related fraud. In 2019, the Department of Justice brought charges against telehealth executives and physicians for $1.2 billion in taxpayer losses after ordering unnecessary back, shoulder, and knee braces. In a separate scheme, Medicare was fraudulently billed $2.1 billion for cancer genetic tests. The Telehealth Extension Act’s anti-fraud provisions will complement the Department of Justice’s investigative and enforcement actions to prevent future scams and billions of dollars of losses to Medicare.
 
“The COVID-19 pandemic has shifted how rural Americans receive health care in fundamental ways. Seniors can now see their doctor from the comfort of their own home, and families can visit the doctor on hours that work for their schedule. Unfortunately, many of the telehealth flexibilities families have come to rely on are going to expire,” said Congressman Kelly. “This bill extends those, then goes further to lower barriers to health care for rural and underserved areas. I’m proud to be co-leading this bipartisan effort and am grateful to all of my colleagues for their tireless efforts on behalf of all Americans.”

“As Americans overcome Zoom fatigue and vaccinations enable many to return to the office and classroom, one aspect of virtual life is here to stay. Expanded access to telehealth, permitted by emergency waivers, has transformed health care delivery—helping patients connect easily and safely with their physicians in a timely manner. As the pandemic enters an unpredictable new stage and emergency waivers may expire, patients and providers should not face a cliff of uncertainty,” said Congressman Doggett. “This forward-looking bill, based on expert, independent recommendations, provides clarity, certainty, and a foundation for building a telemedicine system that expands access, preserves patient choice, and includes basic safeguards against fraud and exploitation.”

“As America emerges from the COVID-19 pandemic, Congress continues to make great strides in providing Americans—especially rural Americans—with access to quality healthcare by expanding telehealth,” said Congressman Nunes. “In particular, this legislation will extend key COVID-19 emergency telehealth waivers for another two years so that healthcare providers and Critical Access Hospitals can continue delivering telehealth services to the Americans who most need them.”

“Expanding telehealth has been a policy focus throughout my time in public service, since my days in the California State Senate. Telehealth is a cost-effective and efficient way to deliver health care, particularly for rural and underserved areas. Today as Co-Chair of the Telehealth Caucus, I am proud to join Chairman Doggett in introducing the Telehealth Extension Act, important bipartisan legislation to make telehealth available for more patients no matter where they receive care. I look forward to advancing this and other important bills to increase the use of telehealth beyond the COVID-19 pandemic,” said Congressman Thompson.

“I am proud to introduce this bipartisan legislation that will protect patient access to a vital healthcare tool. Throughout the pandemic, telehealth has proven time and again to deliver high-quality care to individuals regardless of where they live,” said Congressman Schweikert. “This legislation is a critical step to increase accessibility, improve outcomes, and equip our nation with the tools it needs to respond to future emergencies. I look forward to working with my colleagues to protect access to telehealth for each and every American.”


The Telehealth Extension Act would:

· Permanently lift geographic and site-based restrictions so Medicare beneficiaries can use telehealth regardless of their zip code, and in the comfort and convenience of their own home or at designated health facilities offering telehealth.

· Support the adoption of telehealth in underserved communities by ensuring Federally Qualified Health Centers, Rural Health Clinics, Indian Health Service facilities, and Native Hawaiian Health Care Systems can furnish telehealth services.

· Provide a two-year temporary extension of COVID-19 emergency telehealth waivers. These waivers include permitting providers like Speech Language Pathologists, Occupational Therapists, and Physical Therapists to furnish telehealth services; enabling Critical Access Hospitals to continue providing outpatient behavioral therapy services through telehealth; and permitting payment for appropriate audio-only services.

· Promote program integrity with reasonable guardrails for a small subset of telehealth services that have been targets of fraud without limiting patients’ access to care. The bill would require an in-person appointment within 6 months prior to ordering high-cost durable medical equipment (DME) or major clinical laboratory tests. The legislation also authorizes CMS to audit outlier physicians ordering DME and lab tests at high rates and recover fraudulent payments. Finally, CMS will track who is billing for DME and lab tests by requiring providers to use their own national provider identifier (NPI) when billing Medicare for a telehealth service.

· Improve disaster preparedness by providing broad authority for CMS to authorize telehealth flexibilities during future emergencies.

 

Endorsed by: the National Rural Health Association, the National Association of Rural Health Clinics, the American Occupational Therapy Association, the American Physical Therapy Association, the American Speech-Language-Hearing Association, the American Heart Association, the American Nurses Association, the American Academy of Neurology, Executives for Health Innovation (eHealth Initiative), the Healthcare Information and Management Systems Society (HIMSS), National Association for the Support of Long Term Care, the Texas Organization of Rural & Community Hospitals, Texas Association of Community Health Centers, People’s Community Clinic, Psychiatric Medical Care, and Postpartum Support International.

“The American Nurses Association is proud to endorse the Telehealth Extension Act. This legislation will improve patients’ ability to visit their providers and access health care virtually beyond the COVID-19 public health emergency. By modernizing telehealth provisions to improve access to care, patients will not have to worry about making the painful choice between paying for gas to get to needed health care services or paying for food that week. This bill will also better help people in underserved communities by ensuring Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Indian Health Service facilities, and Native Hawaiian Health Care Systems can furnish telehealth services.” – Ernest Grant, PhD, RN, FAAN, President of the American Nurses Association

“The National Rural Health Association (NRHA) applauds Representatives Doggett, Nunes, Thompson, Schweikert, and Kelly for introducing the Telehealth Extension Act of 2021. Telehealth flexibilities have been the true silver lining throughout the COVID-19 pandemic. It is critical to continue support for telehealth beyond the duration of the public health emergency. NRHA urges Congress to advance the Telehealth Extension Act of 2021 to ensure rural providers are able to continue to partake in the health care delivery system of the 21st century.” – Alan Morgan, Chief Executive Officer of the National Rural Health Association

“Throughout the Coronavirus Disease 2019 (COVID-19) public health emergency (PHE), the Centers for Medicare & Medicaid Services (CMS) has used its authority provided by Congress to cover key audiology and speech-language pathology services delivered through telehealth. However, that authority expires once the COVID-19 PHE ends. Extending this authority for two years after the PHE expires, as called for under Section 7 of the Telehealth Extension Act of 2021, will ensure continuity of care for beneficiaries while Congress considers more permanent telehealth changes. … ASHA applauds your leadership of the Ways and Means Committee’s Subcommittee on Health and appreciates your support for extending current telehealth waivers beyond the COVID-19 PHE.” – American Speech-Language-Hearing Association

“The COVID-19 pandemic has highlighted the barriers that many patients face in accessing care, regardless of where they are located. Telehealth has proven to be a critical tool to bridge those barriers, and it is essential that the policies put into place during the pandemic are made permanent,” said Jen Covich Bordenick, CEO, Executives for Health Innovation (EHI). “EHI is proud to support the Telehealth Extension Act as it will permanently remove Medicare geographic restrictions, allow Medicare beneficiaries to receive telehealth in their homes, and permit safety net providers to continue to provide telehealth services, all key priorities of our members. We urge Congress to act swiftly on these important provisions.”

"The use of telehealth has been instrumental in providing care while keeping patients and providers safe during the public health emergency," said Nathan Baugh, Director of Government Affairs for the National Association of Rural Health Clinics. "While the temporary telehealth policy created by the CARES Act was a step in the right direction, we need to pass the Telehealth Extension Act if we want to unlock the full potential of telehealth for rural communities."