Introduction from the Medicare Rights Center
The Medicare Rights Center appreciates the potential for Medicare telehealth expansions to increase access to care. We have long supported allowing Medicare beneficiaries to obtain critical behavioral health services, including some furnished by opioid treatment programs, remotely—regardless of where they live and from their own home. We have recently noted that such flexibilities may also be appropriate to apply more broadly.
These and other questions about the future of Medicare telehealth coverage are at the forefront due to temporary policy changes that have made these services more widely available during the COVID-19 pandemic. As Congress, the Trump administration, and stakeholders consider the post-pandemic telehealth landscape, we join the Center for Medicare Advocacy in offering our shared perspective on next steps. In the joint statement and principles below, we urge a cautious, thoughtful, and evidence-based approach that centers the unique and evolving needs of people with Medicare.
Joint Principles from the Center for Medicare Advocacy and the Medicare Rights Center
During the COVID-19 public health emergency, legislative mandates and administrative authorities have allowed the Centers for Medicare & Medicaid Services (CMS) to issue temporary Medicare waivers and rules. Combined, these policies have let beneficiaries receive a wider range of health services from home, from a broader array of providers, and using more types of technology.
Although the country is still in the midst of the COVID-19 crisis, some stakeholders are already pushing to permanently extend many of these new flexibilities. Concurrently, CMS has signaled a willingness to do so through rulemaking, and there is bipartisan support in Congress for legislative action.
We recognize the recent expansion of Medicare-covered telehealth services has helped beneficiaries and their families safely and responsibly obtain needed care during this unprecedented time—likely leading to improved outcomes and reduced transmission of the COVID-19 virus. We applaud these successes and understand the impulse to keep many of the underlying policies in place. However, doing so would risk reflexively locking in an unexamined expansion of services that was developed for and during a crisis. Instead, we urge Congress and the Administration to move forward deliberately. Any policy changes should be directly informed by the current experience with telehealth and made through existing legislative and regulatory processes that allow for public comment and stakeholder input.
We are concerned that without careful study and evaluation concerning the expansions—including the types of services being provided; consumer participation and utilization barriers; changes in program and beneficiary spending; quality measures, including patient satisfaction; as well as impacts on beneficiary health and any disparities—calls for and steps toward permanence are premature. Further, policy decisions made without this critical information could fundamentally change the care delivery landscape for people with Medicare in unanticipated, and potentially unwelcome, ways.
While telehealth’s potential may not yet be fully realized, neither are its pitfalls. An intentional and aware approach to post-pandemic expansion is needed to safeguard and advance beneficiary health and well-being.
The following principles are intended to aid such a process. When making decisions about whether and how to expand Medicare coverage for telehealth, we urge policymakers to:
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