AMGA recently sent a letter to the Congressional Telehealth Caucus, agreeing that updates should be made to the CONNECT Act to allow providers the ability to continue providing telemedicine with greater flexibility than pre-pandemic. In addition to recommending Congress permanently extend the current telehealth flexibilities and ensure continued payment parity of telehealth services, AMGA further recommended the continuation of payment parity of audio-only services and removing state licensing restrictions for telehealth services.
Geographic Limitations
Through the Consolidated Appropriations Act of 2023, Congress waived Medicare’s telehealth originating site and geographic limitations regulations through December 31, 2024. By waiting the geographic limitations, AMGA notes that “a new avenue” was opened for AMGA members to “connect with their patients throughout the pandemic” by expanding their telehealth services to patients, “often increasing from 10 telehealth visits per month to an average of 2,000 telehealth visits per week.”
Payment Parity for In-Office and Telehealth
The letter also references “significant investments” made by AMGA members in telehealth modalities and platforms to ensure their patients have access to care. AMGA points out that “without payment parity between telehealth services and in-person care, telehealth will be disincentivized, even if the geographic and originating site restrictions are eliminated, potentially leading to less access to care.”
Continued Payment for Audio-Only Services
The letter also notes that reimbursement for audio-only services “should be equivalent to video telehealth and in-person care, as the resources needed to deliver this care are the same” because audio-only care “is crucial in addressing the current gaps in access to digital health and is a key to addressing health equity.” The letter also advocates for allowing audio-only visits to satisfy the face-to-face requirement for collecting diagnoses for risk-adjustment and care coordination purposes.
State Licensing Restrictions
Finally, the letter advocates for removing state licensure and credentialing policies that would restrict how and where providers deliver care. The letter notes that “superior healthcare delivery involves a team-based, collaborative approach, where providers who provide the best overall value are utilized, regardless of their U.S. location.” AMGA believes that policymakers should create a “national standardized licensing and credentialing system for telehealth so patients can have access to care where quality, value, and cost are the main drivers.”
AMGA Telehealth Survey
AMGA also conducted a brief survey on telemedicine, with responses from AMGA members. One of the questions was “if payments for telehealth visits are reduced, what is the impact on the telehealth services offered by your organization?” 92% of respondents noted that it would result in a decline in access to telehealth while only 8% said it would have no impact. When asked to compare costs for providing telehealth services versus in-person services, 68% of respondents said there was “limited or no difference in expense to provide telehealth visits than in-person visits,” 8% said that the “cost to provide telehealth visits is more than in-person visits,” and 24% said the “cost to provide telehealth visits is less than in-person visits.”
AMGA Statement
“AMGA appreciates Congress’ willingness to extend telehealth flexibilities with the Medicare program until the end of 2024 through the passage of the Consolidated Appropriations Act of 2023,” said Jerry Penso, MD, MBA, AMGA president and CEO. “To ensure that patients have access to their providers where they want it and how they want it. We urge Congress to permanently codify the current telehealth flexibilities.”