Legislation | August 2021 Hearing Review

By Bridget Dobyan

Now with the pandemic in retreat, lawmakers are considering the appropriate scope of telehealth services, reimbursement policies, and patient access, to name just a few issues. In a rare area of bipartansanship, US legislators could be on the threshold of a transformative time in health policy and the delivery of healthcare.

Faced with the pandemic, healthcare professionals innovated and patients adapted to new technologies and procedures to safely administer and access healthcare. However, it is possible that flexibilities granted to support telehealth during the public health emergency could end unless lawmakers act. The federal government has indicated it will continue the public health emergency until the end of 2021, but many states are ending their emergency declarations as the country recovers and reopens. This article provides an overview of proposed policies, areas of focus for policymakers, and the future permanency of telehealth at the state and federal level. Lawmakers are considering the appropriate scope of telehealth services, reimbursement policies, and patient access, to name just a few. 

At the federal level, congressional committees are looking closely at the future of telehealth, particularly in the context of Medicare, following the dramatic increase in use of telehealth services over the last year. Multiple hearings focused on telehealth have been held, including by the US House Energy & Commerce Committee, House Ways & Means Committee, and US Senate Finance Committee. 

Members of Congress have also introduced multiple pieces of legislation in support of telehealth, including the CONNECT for Health Act, bipartisan legislation introduced in the US Senate and US House of Representatives to make permanent certain telehealth flexibilities, including eliminating geographic site restrictions and expanding originating sites (to continue to allow patients to receive telehealth services from their own home) and more. Similar legislation that would make permanent certain telehealth flexibilities, the Protecting Access to Post-COVID-19 Telehealth Act, has been introduced in the US House of Representatives, led by the co-chairs and members of the Congressional Telehealth Caucus. The bipartisan Telehealth Modernization Act, with companion bills in both the House and Senate, also seeks to make permanent certain telehealth flexibilities.

Additionally, federal legislation has been introduced to support the provision of telehealth services across state lines (the TREAT Act) during and for a period following the public health emergency. At the state level, work on the Audiology and Speech-Language Pathology Interstate Compact (ASLP-IC) began years ago and just recently crossed the necessary threshold for the commission to begin drafting the rules and bylaws to create an interstate licensing system for states that have adopted the compact. This would allow for audiologists and speech-language pathologists to provide care in multiple states, either in person or virtually, which could enable them to continue caring for patients who may have moved to another state.

This is by no means an exhaustive list of federal or state legislation that has been introduced this year in support of telehealth, as lawmakers continue to hold hearings, meetings, and introduce new bills. In a year full of competing legislative priorities, it is uncertain as to what telehealth policies may advance, whether they may be added on to a larger legislative package, or possibly pushed off until later in the legislative session. What this list does show is the interest of lawmakers in telehealth and in getting future policy right.

There is enthusiasm around and bipartisan interest in the future of telehealth, but there is also support for taking a step back and fully assessing the use and impact of telehealth during the pandemic. This includes considering the potential for increased costs and concerns around preventing waste and fraud, particularly with federal programs such as Medicare, as well as ensuring the services provided via telehealth are on par with those provided in-person. To address these concerns and to provide time to assess the future of telehealth outside of the unique circumstances presented by the COVID-19, proposals may also include temporary extensions of telehealth flexibilities beyond the public health emergency to gather additional data and evidence on which to base long term or permanent policies.

Critically, COVID-19 telehealth flexibilities also raised visibility of existing disparities in healthcare. During the pandemic, telehealth coverage was expanded in many programs to not only video telehealth visits, but to audio-only appointments as well to provide access to the millions of Americans who live in rural or economically challenged areas and may not have the ability to meet with a medical professional via computer or video call. Going forward, the future of telehealth includes discussions of investments in broadband infrastructure needed to ensure equitable access to telehealth services for all.

Telehealth can provide a platform for innovation, increased access to services, and an opportunity to address disparities in healthcare. Telehealth is a rare area of bipartisan enthusiasm, and we could be on the threshold of a transformative time in health policy and the delivery of healthcare.

Correspondence can be addressed to: Bridget Dobyan at: [email protected].

Citation for this article: Dobyan B. Bipartisanship? It could be possible with telehealth. Hearing Review. 2021;28(8):14.