U.S. Needs Permanent Telehealth Fix, AAFP Tells Congress

Noting that some 70% of family physicians say they plan to continue providing more telehealth services in the future, the AAFP called on lawmakers to increase “equitable access to high-quality telehealth services, such as those provided by primary care physicians within a patient’s medical home.

“Congress must act to extend Medicare telehealth flexibilities and ensure telehealth is permanently recognized across payers as a valuable modality of providing primary care services.”

The letter was offered as testimony ahead of a March 2 hearing titled “The Future of Telehealth: How COVID-19 is Changing the Delivery of Virtual Care.” It was sent to Reps. Anna Eshoo, D-Calif., and Brett Guthrie, R-Ky. — the chair and ranking member, respectively, of the subcommittee — and signed by Board Chair Gary LeRoy, M.D., of Dayton, Ohio.

Citing joint principles for telehealth policy conceived by the AAFP along with the American Academy of Pediatrics and the American College of Physicians, the letter cautioned that revised telehealth policy must preserve and augment the physician-patient relationship and center on strong continuity of care.

With that in mind, the Academy urged lawmakers to

• permanently remove section 1834(m) geographic and originating-site restrictions to ensure that all Medicare beneficiaries can access care at home (as the Academy has repeatedly asked);
• require Medicare to cover audio-only evaluation and management services beyond the public health emergency;
• standardize coverage and payment of telehealth services across payers, with steps that include requiring coverage of in-network telehealth services and prohibiting policies that cover only telehealth services provided by separately contracted virtual-only vendors; and
• permanently ensure that beneficiaries can access telehealth services provided by federally qualified health centers and rural health clinics.

To minimize administrative complexity for primary care practices, the Academy suggested that existing Medicare policy and definitions remain the standard where appropriate.

“For example, Medicare defines an established patient as one who has received professional services from a clinician in the same practice and of the same medical specialty within the last three years. This definition should be repurposed in new telehealth policies instead of creating a new definition for an established patient that could conflict with current coding guidelines.”