Recently, the Federal Trade Commission (FTC) submitted a comment to the Centers for Medicare & Medicaid Services (CMS) in support of reducing reimbursement requirements for telehealth services. The CMS rule changes the Medicare payment regulations to allow for more flexible Medicare service options in response to the COVID-19 pandemic. In its comments, the FTC’s recommends permanent measures and further steps to take. The comment offers a valuable insight into the Commission’s stance on telemedicine in relation to health care competition.
FTC Comments
The FTC responded to a major change in the CMS rule which allows for Medicare reimbursement of telehealth services provided to patients at any location, including their home. The FTC suggested the change should last beyond the duration of the current public health emergency and urged CMS to consider a permanent rule. According to FTC, the normal “originating site” geographic requirement for telehealth reimbursement limits new entrants in the health care market.
The FTC also supported expanding the scope of telehealth services. In the rule, CMS authorizes more than 80 types of telehealth services not previously covered for reimbursement. These services include emergency visits, initial nursing facility and discharge visits, intensive care unit services, and home visits. The FTC recommended that CMS consider making these changes permanent after further research of the interim rule’s impact.
Additionally, FTC recommended that CMS remove altogether its “direct supervision” requirement for advanced practice registered nurses (APRNs) and physician assistants (PAs). The FTC believes requiring direct physician supervision at all is “a vestige of a time when advanced practice registered nursing and physician assisting were nascent professions.”
This is also not the first time the FTC has weighed in on telehealth services. In 2004, the Commission co-authored a report with the Department of Justice on health care competition writ large, which recommended uniform licensing requirements and fewer state restrictions for telehealth services. This point was recently reiterated in the FTC’s 2018 policy report on occupational license portability.