“Virtually overnight, our health-care system underwent a significant transition,” said Guthrie, a Republican who represents the 2nd Congressional District and chairs the health subcommittee of the House Energy and Commerce Committee, according to a press release from the committee.
“Seniors were allowed to use telehealth across the country and could now access their health-care providers from the comfort of their home. Additionally, the number of health care services Medicare would cover if performed through telehealth increased from 118 to over 260.
“Restrictions such as requiring seniors to have an established pre-existing relationship with a health-care provider to receive mental health services through telehealth were waived. Allowing patients to consult with a provider through a simple audio-only phone call if an audio-visual connection wasn’t available.”
All those things were a big help to rural communities, Guthrie said, so Congress has extended them through Dec, 31. But he added that before they can be extended again or made permanent, some problems need to be addressed.
“I want to remind my colleagues that the previous extension was estimated by the Congressional Budget Office to increase costs to the Medicare program by over $2 billion,” Guthrie said. “Making these authorities permanent is likely to cost much more than a short-term extension, and we want to make sure that whatever we move out of committee is paid for and is delivering the best value for seniors. I think that this committee can work together, to move legislation making sure seniors have access to telehealth when they want it while also including appropriate program integrity measures, addressing the costs of such access to the program.”
Politico Pulse reports, “Generally, lawmakers seemed willing to accept higher costs to expand access to virtual care.” Rep. Cathy McMorris Rodgers (R-Wash.), chair of the full committee, said extending telehealth rules would be a “significant investment” but “We can’t afford to go backwards.” Pulse notes, "Harvard researcher Ateev Mehrotra told lawmakers that expanded telehealth is associated with a 'modest' increase in spending but also improved outcomes, particularly in mental health."
Guthrie largely dismissed concerns about increases in waste, fraud, and abuse from telehealth. “It appears that telehealth can be used to deliver care without actually raising those serious concerns. According to the Office of Inspector General, of the over 700,000 providers they studied who provided telehealth care during the pandemic, less than 2,000 warranted further scrutiny resulting from their telehealth billing practices, and mostly because they charged facility fees and for the actual telehealth visit.”
The full committee's ranking Democrat, Rep. Frank Pallone of New Jersey, acknowledged the budget implications of extending telehealth, but noted that the CBO has not estimated the cost yet. "I would like to better understand the offsets for these proposals," he said, "and want to ensure that it would not result in significant funding cuts to the Medicare program or raise health care costs for seniors."
Pallone also said, "I believe that any further expansions of telehealth flexibilities in Medicare must meaningfully increase patient access to care and ensure high quality care for seniors. . . . Congress must ensure that additional expansions of telehealth policies do not limit access to in-person care. It is important that we preserve patient choice and that Medicare beneficiaries continue to have access to high quality in-person care and robust consumer protections, including network adequacy standards."
The top-ranking Democrat on the subcommittee, Rep. Anna Eshoo of California, voiced concern about the health-care industry “gaming” telehealth to make it into a “cash cow.”
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