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As the federal government shutdown drags into its third week, there are renewed calls for Congress and the Trump administration to address escalating disruptions to virtual care services, which began when lawmakers failed to pass the latest Medicare telehealth and the Acute Hospital Care at Home program extensions, and they expired on Sept. 30.
WHY IT MATTERS
With no legal basis to uphold the coverage once the government shut down on Oct. 1, healthcare organizations that have invested in and expanded telehealth and remote care services since the COVID-19 pandemic now face significant risks, according to Kyle Zebley, senior vice president, public policy at the American Telemedicine Association and executive director of ATA Action.
"We’re hearing from many hospitals and healthcare systems that they are continuing to provide telehealth services to Medicare patients during the shutdown, hoping they will receive retroactive reimbursement once the government reopens," said Zebley Tuesday in a statement – but none of that reimbursement is guaranteed.
Patients who have come to rely on these services through flexibilities authorized by lawmakers for five years are also at risk, especially in underserved and rural areas.
"Lifepoint hospitals and clinics operate in rural and underserved regions which depend on telehealth to connect patients with specialists, behavioral health providers and hospital-level care that would otherwise be out of reach," explained Sara Collins, assistant vice president, professional medical affairs and telehealth for Lifepoint Health and a member of the ATA Policy Council.
"The expiration of Medicare telehealth flexibilities has an immediate and deeply concerning impact on patients and providers across the communities we serve," she said in the ATA statement.
Threats to the continuity of care also extend beyond Medicare access to millions of privately insured Americans.
Commercial insurers align coverage and payment decisions with federal reimbursement policies, so uncertainty in the marketplace is growing as lawmakers have not yet assured retroactive reimbursement, ATA said.
While most commercial payers continue to offer critical virtual care services to their beneficiaries, some providers have told patients that they are ultimately responsible for the full cost of services if retroactive payments are not granted.
Providers have been forced to make difficult choices about sustaining virtual care, said Zebley: "The impact on healthcare delivery, and on patients’ wellbeing nationwide, is deeply concerning."
THE LARGER TREND
While ATA Action has long pushed for permanency through each sequential waiver extension granted under bipartisan support, it's urging lawmakers to restore the flexibilities immediately, despite the shutdown.
"President Trump wisely passed these flexibilities in 2020, at the outset of the pandemic," Zebley said. "The President and countless members of Congress, from both parties, have championed telehealth as an important part of a modernized healthcare delivery system, and for that, we are grateful.
"Now is the time to, once again, set aside political differences and prioritize the health of Americans, including many of the most vulnerable, to ensure that patients have access to needed healthcare, where and when they need it."
Telehealth quickly became more than a pandemic trend. Providers, who have crowded schedules, save time and money and serve more patients with telemedicine, while patients overwhelmingly support access to virtual care.
"Telehealth is not a temporary fix; it’s the basis of modern healthcare," Collins added. "We urge bipartisan collaboration to restore these vital flexibilities and safeguard access to care for the patients and communities who need it most."
ON THE RECORD
"As expected, the lapse of the Medicare telehealth flexibilities and absence of clear federal policy is disrupting care and creating anxiety across the healthcare system, which is already impacting patients and providers," said Zebley in a statement. "We also commend the many commercial insurers that have continued telehealth coverage during this lapse, recognizing that patients depend on these services now more than ever."
Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.
