The American Hospital Association sent an open letter to President Donald Trump this week recommending actions that the U.S. Department of Health and Human Services should take to safeguard patient access to telehealth after the public health emergency ends.

The president issued an executive order in early August in support of making some temporary flexibilities for telehealth permanent, though it did not include many specifics. 

In its letter, which it also addressed to HHS Secretary Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma, AHA advised the administration to take a series of steps in response to the order.

“We urge the Administration to work with the AHA and Congress to create a future for telehealth that allows not only clinicians, but also hospitals and health systems, to code and bill for virtual services,” wrote president and CEO Richard J. Pollack.

WHY IT MATTERS

In response to the COVID-19 pandemic, federal policymakers enacted dozens of changes to expand access to telehealth. 

“The AHA and our members appreciate the speed at which the Administration has acted to allow hospitals to preserve in-person capacity for the sickest patients and continue to serve other patients via telehealth,” wrote Pollack, noting that patient interest in and use of telehealth has increased accordingly. 

The AHA urged HHS and CMS to make a number of the temporary flexibilities permanent.

These included expanding the list of Medicare telehealth services to include those that were added during the pandemic; allowing virtual check-ins and e-visits to be used for new and established patients; allowing remote patient-monitoring to be used for new and established patients, and for acute and chronic conditions; and allowing direct supervision to be provided using real-time, interactive audio and visual technology.

The AHA also said the agencies should give hospitals the flexibility to obtain annual beneficiary consent to telehealth treatment at the same time services are provided, and not necessarily before, and that they should preserve hospitals’ ability to capture diagnoses impacting risk adjustment during telehealth visits.

“Finally, we strongly recommend HHS and CMS develop a mechanism to cover and pay for audio-only telehealth services, given the essential role of such services in ensuring rural patients stay connected to their providers,” the letter continued. 

THE LARGER TREND

The future of telehealth regulations has continued to be a hot topic over the last few months, with lawmakers on both sides of the aisle introducing legislation to expand access in a variety of ways.

Stakeholders point out that permanently relaxing existing telehealth requirements won’t be enough, though – comprehensive access to telehealth must also include robust broadband expansion. 

“Now that [providers] are authorized under emergency legislation to reach directly to patients at their home, bandwidth is a big issue, and we’re beginning to focus on that, and discussing that with the FCC,” said Federal Office of Rural Health Senior Adviser for Telehealth William England during the ONC Tech Forum this month. 

“Reaching patients in their home – if they don’t have good self-coverage, broadband or bandwidth – telehealth is a significant challenge,” he continued.

ON THE RECORD

“Patients have been empowered by this flexibility to seek and receive virtual care at all of the places they can currently access in-person care, including hospital outpatient departments. They have found that the convenience, quality and ease of receiving care in this manner helps accommodate their individual needs and lifestyles, creating a more patient-centered care experience. As such, it is imperative that hospitals and health systems be able to continue providing high-quality virtual care for their patients and communities,” wrote Pollack in the letter.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Healthcare IT News is a HIMSS Media publication.

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