US Sens. Susan Collins (R-ME) and Angus King (I-ME) are co-sponsoring the Telehealth Modernization Act, which aims to solidify access to and coverage of telehealth services for Medicare beneficiaries. The bipartisan legislation would eliminate Medicare’s geographic and originating site restrictions and establish policies that ensure Medicare coverage for telehealth services, which would also include O&P billing codes.
At the start of the COVID-19 pandemic, Congress introduced temporary emergency waivers to ensure Medicare beneficiaries could access and receive coverage for virtual care services. According to the Department of Health and Human Services (HHS), the use of telehealth to deliver healthcare services skyrocketed during the COVID-19 pandemic. Almost half (43.5 percent) of all Medicare fee-for-service (FFS) primary care visits were conducted via telehealth in April 2020. Usage remained high during the first year of the public health emergency. According to HHS, from January to December 2020, nearly 52.7 million Medicare FFS beneficiaries used telehealth, a 63-fold increase from the year prior.
According to an informal poll conducted by The O&P EDGE last year, 58 percent of those who responded said telehealth was somewhat important or very important to O&P clinicians and patients.
Unless Congress takes action, the emergency flexibilities are set to expire at the end of the public health emergency, which has been extended at least through April 16.
The bill would permanently eliminate Medicare’s geographic and originating site restriction. This restriction limits patients’ access to telehealth by requiring that Medicare beneficiaries live in rural areas and be present at a doctor’s office or other specified clinics in order to receive virtual healthcare services that are covered by their insurance. The legislation would also ensure that individuals living in rural areas continue to have access to virtual care by requiring Medicare to provide coverage for telehealth services provided at federally qualified health centers and rural health clinics.
“Telehealth services have been a lifeline to patients and providers during the pandemic, ensuring that individuals can continue to receive quality healthcare from the safety and convenience of their own homes,” Collins and King said in a joint statement.