Access to healthcare has long been a challenge for many Americans. The COVID-19 pandemic only exacerbated these issues as strains on the medical system and lockdowns complicated care. Policymakers tried to preserve access to medical care during the pandemic by expanding coverage for a number of telehealth services, including some federal-level expansions for Medicare participants. However, these allowances will expire with the COVID-19 public health emergency period, which some legislators are asking the Biden administration to end. This could leave patients and providers scrambling to transition back to exclusively in-person visits.

Recognizing this, Sens. Catherine Cortez Masto (D-Nev.) and Todd Young (R-Ind.) introduced bipartisan legislation, “The Telehealth Extension and Evaluation Act,” to extend telehealth flexibilities for Medicare participants for two years after the COVID-19 public health emergency period expires. Although the bill primarily extends some pandemic-induced Medicare telehealth allowances, it maintains some key provisions that will strengthen the state of telehealth access.

Prior to the COVID-19 public health emergency, telehealth for Medicare was highly restricted and rarely used. Centers for Medicare & Medicaid Services rules restricted many providers from offering telehealth services. Generally, only participants in rural areas were qualified to use telehealth, and originating site requirements restricted patients from using telehealth from home. The Telehealth Extension and Evaluation Act preserves an expanded list of allowed services and widens the scope of providers and patients allowed to use telehealth. It also extends the ability for providers to prescribe controlled substances via telehealth visits. This has particularly important implications for people using medication-assisted treatment to treat opioid use disorders.

Another provision of the bill allows critical access hospitals, rural health clinics and federally qualified health centers to continue providing telehealth services. Since these facilities were not authorized to provide telehealth services prior to the COVID-19 pandemic, this maintains expanded access to telehealth for populations that often face financial or geographical barriers to care.

Although not every medical visit is suited to a telehealth visit, the surge in telehealth use during the pandemic has emphasized the need to reform related policies permanently. Telehealth has provided innovative avenues to medical care access, including for mental health care and for patients without internet access. Pre-pandemic, Medicare patients and providers faced a complex and highly restrictive telehealth regime, but temporary allowances facilitated an unprecedented increase in Medicare telehealth visits.

The Telehealth Extension and Evaluation Act is an important step to maintain expanded telehealth access for Medicare beneficiaries beyond the end of the COVID-19 public health emergency period. It also lays the foundation for Congress to make telehealth coverage permanent. However, since Medicare only covers a portion of Americans, additional legislation to extend telehealth coverage for other groups should follow. In fact, Sen. Cortez Masto has already introduced legislation to expand telehealth coverage for Americans on high-deductible insurance plans.

Ensuring more avenues for people to obtain care decreases barriers to maintaining health. The Telehealth Extension and Evaluation Act is a valuable step in making permanent strides in telehealth access.

Image credit: bongkarn

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