The Medicare telehealth flexibility granted to physical and occupational therapists since the start of the COVID-19 pandemic is about to expire, again. But newly introduced bills seek a two-year extension.
After multiple telehealth extensions throughout the pandemic’s public health emergency (PHE), the current waiver is due to end on Sept. 30, unless Congress takes action. And on Sept. 2, H.R. 5081 and S. 2709 — the Telehealth Modernization Act — were introduced by Reps. Buddy Carter (R-Ga.) and Debbie Dingell (D-Mich.) in the U.S. House of Representatives, and by Senators Tim Scott (R-S.C.) and Brian Schatz (D-Hawaii) in the U.S. Senate.
Advocacy efforts for telehealth coverage
In the spring of 2020, the Centers for Medicare & Medicaid Services (CMS) announced a telehealth waiver “to ease the use of telecommunications technology as a safe substitute for in-person services.” Included on the list were a number of physical therapy, occupational therapy and speech language pathology services.
“On an interim basis, CMS eliminated several requirements associated with particular services provided via telehealth,” a May 2020 MLN Matters publication said. “CMS clarified several payment rules that apply to other services that are provided using telecommunications technologies that can reduce exposure risks.”
The telehealth waiver was renewed as the PHE was renewed. The COVID-19 PHE officially expired May 11, 2023, but the telehealth waiver continued.
In a Sept. 9 bulletin, the American Physical Therapy Association (APTA) said, “Thanks in part to advocacy by APTA members, Congress has extended the Medicare telehealth waivers every time they have approached expiration since their implementation. While there is broad bipartisan support for extending the current telehealth waivers, the question is whether Congress will be able to act by the Sept. 30 deadline, which is also the deadline for Congress to fund the federal government or risk another government shutdown.”
“Telehealth services have proven to be an effective option for certain patients, especially those in rural and underserved communities,” said APTA Congressional Affairs Specialist Steve Kline in the announcement. “Telehealth offers options for access when traveling long distances can be a major barrier to continuity of care. APTA urges Congress to act swiftly and make this telehealth policy permanent.”
APTA said it continues to support H.R. 1614, which would “expand practitioners eligible to furnish telehealth services under the Medicare program,” according to the bill’s text.
On Sept. 8, the American Occupational Therapy Association (AOTA) expressed support for the new twin House and Senate bills.
“The Telehealth Modernization Act also includes other provisions that are essential to maintaining and enhancing the use of telehealth in Medicare,” AOTA said in the announcement. “If no action is taken by Congress this month, the vast majority of telehealth options for Medicare beneficiaries including access to occupational therapy via telehealth will end.”
An extension while working toward permanent coverage
“AOTA has lobbied for legislation that would establish OTPs as permanent telehealth providers in Medicare and to extend existing waivers until a final policy is established,” the announcement added. “Representatives Mike Kelly (R-Pa.), Mike Thompson (D-Calif.) and Adrian Smith (R-Neb.), have already reintroduced legislation (H.R. 1614), which would make OTPs [occupational therapy practitioners] as well as other therapy providers permanent Medicare telehealth providers. In addition, AOTA is supporting efforts to reintroduce the Expanded Telehealth Access Act, which would also establish OTPs as permanent Medicare telehealth providers.”
Both APTA and AOTA were among the approximately 350 health-care organizations to sign an Aug. 11 letter addressed to Speaker of the House Mike Johnson (R-La.), House Minority Leader Hakeem Jeffries (D-N.Y.), Senate Majority Leader John Thune (R-S.D.), and Senate Minority Leader Chuck Schumer (D-N.Y.).
“We write today to request your leadership in ensuring Medicare beneficiaries are able to access the same telehealth services that they have been relying on for the past five years,” the letter said. “While we strongly support making Medicare telehealth access permanent, if that’s not achievable at this time, we urge Congress to approve the longest possible extension. At a minimum, a two-year extension is needed to ensure stability and provide clarity for patients, providers and the health-care system as a whole.”
Organizations that signed the letter added that telehealth services provide access to patients even when there are barriers — such as neurodegenerative disorders, weakened immune systems, and travel challenges — to face-to-face medical visits.
“Telehealth is a continuation of standing, bipartisan policy over the last five years and will not lead to new costs,” the letter noted. “It is essential that Congress act swiftly to prevent the expiration of Medicare telehealth services this September, providing sufficient lead time to ensure continuity of care and avoid disruptions for patients and practitioners.”
Among the other organizations signing onto the letter were the ALS Association, American Academy of Hospice and Palliative Medicine, American Academy of Physical Medicine and Rehabilitation, Easterseals, Johns Hopkins University and Medicine, National Center for Assisted Living, Parkinson’s Foundation, Susan G. Komen, The Michael J. Fox Foundation for Parkinson’s Research, University of Michigan Health, University of Pittsburgh Medical Center Health System, UW Medicine, and Yale New Haven Health System.
