Expansion of Medicare telehealth services remains stubbornly controversial. Despite filling important gaps during the early days of the pandemic, people - like the Committee for a Responsible Federal Budget - have questions. The first is some resistance to payment parity. The point of telehealth is greater access to care in an efficient way. Telehealth services cost less to produce and the government's reimbursement should be commensurate. A second concern relates to utilization. Services that are more readily available are generally used more. Finally, and probably most compelling is the potential for abuse.
There is a long standing bias at CMS in favor of brick and mortar providers. Surveyors and inspectors can usually find a building, request files and look the place over. CMS has been long frustrated by the home health providers that submit fraudulent bills and then disappear. Telehealth presents them with an even more daunting task for monitoring improper payments.
The two year extension the House is expected to pass with the vigorous support of the White House should have an easy path to the president's desk. It represents an victory for the industry which sought to separate itself from the administrative waivers implemented in early 2020. It makes the path to ending those waivers a little easier for CMS as well.
If the abortion debate does not get in the way of bipartisan agreement, the telehealth industry's long sought opportunity to present a case that refutes the CRFB and opens the door for a viable CBO score, would be at hand.
Emily Evans
Managing Director – Health Policy
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