With the COVID-19 public health emergency (PHE) set to expire on May 11, 2023, the Alliance for Connected Care wrote a letter to the Centers for Medicare and Medicaid Services (CMS) requesting an interim final rule to ensure that access to Medicare telemedicine services are not cut off and eliminated after the PHE ends.
Currently, some Medicare telehealth codes are set to expire about 5 months (151 days) after the expiration of the COVID-19 PHE. While CMS can extend telehealth codes in the annual Medicare Physician Fee Schedule rulemaking, that timing does not line up with the current expected expiration. Therefore, the Alliance requests that CMS issue an IFR to implement the date changes as per the Consolidated Appropriations Act of 2023, “to align the dates that telehealth policies will expire with the new statutory timeline.”
Krista Drobac, Executive Director of the Alliance for Connected Care, wrote in the letter, “now that authority has been extended to December 31, 2024 [through the Consolidated Appropriations Act, 2023], [telehealth] services should be updated to align through an IFR.”
The Alliance requested an IFR” to implement these date changes and preserve beneficiary access for the latter half of CY2023 and into CY2024,” with more permanent changes made in the CY2024 Medicare Physician Fee Schedule rulemaking.
Consolidated Appropriations Act
In the 2023 Consolidated Appropriations Act, Congress did legislate certain telemedicine flexibilities through the end of 2024. Some of those flexibilities include: Medicare beneficiaries can receive telehealth services from any geographic location; the list of eligible practitioners is expanded to include physical therapists, occupational therapists, speech therapists, and audiologists; Federally Qualified Health Centers and Rural Health Clinics can continue to provide telehealth services; the requirement that mental health providers see a patient in person before providing telehealth behavioral services is waived; and Medicare can cover audio-only services if/when appropriate.
Permanent Medicare changes in the Consolidated Appropriations Act include allowing Federally Qualified Health Centers and Rural Health Clinics to serve as a distant site provider for behavioral and mental telehealth services; allowing Medicare patients to receive telehealth services for behavioral/mental health care in their home; eliminating geographic restrictions for originating site for behavioral/mental telehealth services; allowing behavioral/mental telehealth services to be delivered using audio-only platforms; and allowing rural hospital emergency departments to serve as an originating site.
The Alliance for Connected Care is asking for additional extensions, beyond what was included in the Consolidated Appropriations Act, 2023. HHS has a landing page on its website regarding telehealth flexibilities which notes that “[a]s the public health emergency ends, more resources and guidance will be made available to keep you and your staff up-to-date regarding the latest changes to telehealth policies.”
Additional Concerns
In addition to concerns over the timeline, Drobac requests that CMS “update the timelines on Category 3 codes – creating stability and predictability for patients throughout the congressionally authorized extension of access to telehealth services through December 31, 2024.” This would not only create more predictability for patients and clinicians using those services, but it would also allow CMS and other organizations time to collect data about the clinical benefits of providing these services via telehealth for Medicare beneficiaries.