Third Time’s a Charm? New Legislation Introduced to Remove Medicare Telehealth Restrictions

Oct. 31, 2019
Progress has been made, but legislators believe that Medicare should expand its coverage for telehealth services

Six U.S. senators have introduced legislation aimed to expand the use of telehealth services through Medicare.

If the legislation sounds familiar, there’s a good reason why. The bill, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, will be the third attempt to pass this particular legislation; the CONNECT for Health Act was initially introduced in 2016 and again in 2017 but both times it did not pass Congress.

Senators Schatz (D-HI), Wicker (R-MS), Cardin (D-MD), Thune (R-SD), Warner (D-VA) and Hyde-Smith (R-MS) on Oct. 30 introduced the latest iteration of this bill, which seeks to address key Medicare restrictions for telehealth services.

Currently, Medicare limits the use of telehealth to certain services, providers, technology and patient locations. For example, Medicare limits the location where the patient can be during a telehealth visit—known as the originating site—to only eight facilities, including provider offices, hospitals, crucial access hospitals, rural health clinics (RHCs), federally qualified health centers (FQHCs), skilled nursing facilities, community mental health centers or hospital-based renal dialysis centers.

Notably, a patient’s home is not one of the eight eligible sites. Furthermore, the eight above mentioned sites must be either located in a Health Professional Shortage Area (HPSA) or in a county that is outside any Metropolitan Statistical Area (MSA). These requirements restrict the impact that telehealth can have to Medicare beneficiaries given its narrow scope, the bill’s supporters contend.

The CONNECT Act of 2019 is designed to address both of these restrictions. For mental health services delivered via telehealth, the Act aims to add the home to the list of eight eligible originating sites.

It also seeks to remove the geographic restrictions on all originating site locations and FQHCs, RHCs, and Indian Health Service facilities. Additionally, the geographic restrictions would be lifted for hospitals, critical access hospitals, or skilled nursing facilities for the use of telehealth in emergency medical care services. Other provisions of the bill include:

  •  Providing the Secretary of Health and Human Services (HHS) with the authority to waive telehealth restrictions when necessary
  •  Allowing rural health clinics and other community-based health care centers to provide telehealth services
  • Requiring a study to explore more ways to expand telehealth services so that more people can access health care services in their own homes.

Schatz and the Senate telehealth working group first introduced the CONNECT for Health Act in 2016, and since then progress on removing certain restrictions has been made. A number of provisions have been signed into law or adopted by the Centers for Medicare & Medicaid Services.

The CONNECT for Health Act of 2019 has the support of more than 100 industry organizations including , the American Hospital Association, American Medical Association, American Medical Group Association, the College of Healthcare Information Management Executives (CHIME) and the Healthcare Information and Management Systems Society (HIMSS).

“Telehealth is the future of healthcare. The technology is advancing, more providers and patients are relying on it, and we have broad bipartisan support,” Sen. Schatz said in a statement this week. “This bill will help ensure that every American gets the care they need no matter where they live.”

Companion legislation has been introduced in the House of Representatives by U.S. Representatives Mike Thompson (D-Calif.), Peter Welch (D-Vt.), David Schweikert (R-Ariz.), and Bill Johnson (R-Ohio).

A summary of the Senate legislation can be seen here.