Telehealth use surged in 2020 when CMS waived many statutory restrictions on telehealth to ensure continued access to health care during the COVID-19 public health emergency (PHE). Older adults and individuals from communities that are medically underserved benefited the most from expanded telehealth access. Policymakers on Capitol Hill are now developing legislation to build on certain pandemic-era telehealth provisions, including permanently eliminating geographic and originating site waivers. There are currently multiple competing legislative initiatives, each featuring unique congressional champions and sponsors. Within this potentially confusing environment, here’s how ACCP is working on behalf of clinical pharmacists to ensure the voice of the profession is heard on Capitol Hill.

Background
The Consolidated Appropriations Act of 2023 (2023 CAA) (Public Law 117-328), signed into law on December 29, 2022, extended authorization through December 31, 2024, for certain key telehealth flexibilities established during the PHE. Although this fell short of making permanent all PHE telehealth flexibilities, the 2023 CAA decoupled or untied telehealth from the continued existence of the PHE. This is significant for the long-term future of telehealth as the PHE instituted during the pandemic unwinds.

Click here for a comprehensive summary of telehealth flexibilities addressed in the CAA from ACCP colleagues at McDermott+Consulting.

Current Outlook
Since 2021, Medicare beneficiaries’ telehealth use has stabilized at 15%, and overall health care use is level, indicating that telehealth often substitutes for in-person care (https://oig.hhs.gov/oei/reports/OEI-02-20-00520.pdf).

However, with telehealth flexibilities set to expire at the end of 2024, beneficiaries will lose access to care, including requirements that only permit beneficiaries to receive telehealth services if they are in rural areas and at certain clinical sites. Permanent changes to Medicare’s coverage of telehealth services are critical to protect access to care and fully integrate telehealth into care delivery.

Legislation Under Consideration in the 118th Congress
H.R.3432 – Telemental Health Care Access Act of 2023
Legislation to remove barriers to high-quality, virtual mental and behavioral health care for Medicare beneficiaries:

• Specifically, the bill would remove the requirement that physicians see Medicare beneficiaries in-person within 6 months of being treated virtually for mental and behavioral health concerns. Eliminating this arbitrary in-person requirement will ensure patients can fully leverage telehealth to get the care they need from home.

H.R.134 – To amend title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services
Legislation to permanently eliminate the originating site and geographic limitations for using telehealth, which will help patients continue to receive care through telehealth services regardless of the location of the provider or the patient

CONNECT for Health Act in the 118th Congress (introduced as S.1512/H.R.2903 in the 117th Congress)
Legislation (still in draft form and awaiting introduction in this Congress) aimed at eliminating barriers to telehealth coverage that would:

• Remove geographic requirements for telehealth services
• Expand originating sites to include the patient’s home and other clinically appropriate sites
• Expand the authority of practitioners eligible to furnish telehealth services
• Improve Medicare’s process to add telehealth services
• Permanently allow federally qualified health centers and rural health clinics to furnish telehealth services as distant site providers
• Remove restrictions for facilities of the Indian Health Service and Native Hawaiian Health Care System
• Repeal the 6-month in-person visit requirement for telemental health services
• Permanently allow for the waiver of telehealth restrictions during PHEs

S. 731 – Telehealth HSA Act of 2023/H.R.1843 – Telehealth Expansion Act of 2023
Legislation to amend the Internal Revenue Code of 1986 to make permanent the permissible first-dollar coverage of telehealth services for purposes of health savings accounts

Get Involved
As ACCP advances a coordinated telehealth response together with its pharmacy colleagues and other external stakeholders, the College needs to hear how telehealth has improved your practice. If you are currently delivering care to patients using telehealth services, reach out to ACCP’s Government Affairs team by contacting [email protected]. The team is looking to compile evidence and anecdotal accounts of how clinical pharmacists are improving patient care and outcomes as part of virtually integrated care teams.

Support ACCP-PAC in 2023
Telehealth is just one of the many issues ACCP is currently advocating for on Capitol Hill. The College’s top advocacy priority is still to establish Medicare coverage for comprehensive clinical pharmacy services that optimize medication use for patients.

With the 118th Congress fully underway and the 2024 presidential elections already on the horizon, ACCP has a clear opportunity to raise its profile on Capitol Hill by providing financial support to policymakers who work with the College to advance its issues. ACCP must support these friends on Capitol Hill to ensure leaders remain in Washington to advance policies that meaningfully address the nation’s health care issues.

PAC contributions are a constitutionally protected part of the U.S. political system under the First Amendment’s guarantee of free speech. ACCP-PAC is the only means through which the College can provide financial support for candidates for Congress. With its more than 16,000 members, ACCP is in a position to become one of the most prominent pharmacy PACs in Washington. To do this, the College needs the widespread support of its membership. If each ACCP member contributed just $50, ACCP-PAC would instantly establish itself as the most powerful pharmacy PAC in the entire country. All ACCP members should consider contributing at least $50 to ACCP-PAC. CLICK HERE to support your PAC today!