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Congress added protections to keep telehealth and acute hospital care at home for two years after the public health emergency ends, but many questions remain as to how the expiration of PHE waivers will affect these two programs and others, according to experts with the Connected Health Initiative.
“Candidly, I’ve always been concerned about this day and if it would come. We did not want a snapback to the old days …” said Morgan Reed, president of ACT | The App Association of Monday’s announcement on an end date to the PHE.
One concern is the end of remote monitoring, which is used by hospitals for at-home programs. Hospital-at-home may remain for two years, but the digital connection allowing for the program to operate may not.
“We’re skeptical CMS (Centers for Medicare and Medicaid Services) will enable remote monitoring to continue in the home,” said CHI Executive Director Brian Scarpelli.
WHY THIS MATTERS
Reed and Scarpelli say what is known is that, with the end of the PHE, patients will likely be paying more money for care, and their ability to communicate with their physicians through existing devices will no longer be allowed.
PHE losses include: medical codes to provide some elements of care, including Category 3 codes that are condition-specific telehealth payments, remote support for skilled nursing, live voice video services, virtual check-ins, FaceTime and blood glucose monitoring.
“The real urgency here is the promise of waivers around digital healthcare,” Reed said. “Patients and physicians are going to lose out …”
On January 25, CHI sent Congress a list of priorities to continue the digital innovations that CMS allowed during the public health emergency.
Conversations with political leaders have been productive and supportive, Reed and Scarpelli said, but no bills are forthcoming, and the situation of a divided House and Senate makes it harder for legislators to have consensus on a bill that reaches the president’s desk.
THE LARGER TREND
An estimated 43% of physicians in the United States currently use telehealth services with patient appointments, according to CHI, which is urging Congress to provide maximum statutory flexibility for CMS to cover telehealth visits where appropriate.
Among other recommendations, CHI wants Congress to permanently enable Medicare to cover live audio and video visits, regardless of the location of the patient, and to remain focused on long-term digital health delivery, including wearable devices and software platforms that are eligible for reimbursement.
The White House this week announced the end of the public health emergency on May 11.
Email the writer: SMorse@himss.org