Proponents expect telehealth flexibilities to be extended again
Members of ATA's advocacy group met with lawmakers last week to discuss the future of telehealth flexibilities, including virtual prescribing of controlled substances.
Telehealth flexibilities slated to expire on Sept. 30, 2025, will likely be extended again, though it is unclear how long.
That's according to members of the American Telemedicine Association's advocacy arm, ATA Action. ATA Action members met with more than 40 U.S. representatives, senators and senior legislative staffers during the association's Hill Day event on June 11 to advocate for permanent access to telehealth and digital health tools.
Currently, flexibilities enacted to expand telehealth access during the COVID-19 pandemic will expire at the end of September. However, following discussions with lawmakers and legislative staffers, the ATA Action members believe another extension is on the horizon.
"Another clear signal -- that was essentially universal [among] all those that talked about it at our Hill Day reception or with whom we met -- was that the telehealth flexibilities and Acute Hospital Care at Home [program], which is tied to those flexibilities, will be extended past their current expiration date of the end of September," said Kyle Zebley, senior vice president of public policy at the ATA and executive director of ATA Action. "And it's on the road to permanency."
Some lawmakers said the extension might be relatively short, as little as three months or until the end of this year. While making the flexibilities permanent would be the preferred outcome for telehealth proponents, "anything is better than allowing the flexibilities to lapse," Zebley said.
ATA Action members met with lawmakers on both sides of the aisle, including U.S. Sens. Cindy Hyde-Smith (R-MS), Ron Wyden (D-OR) and John Thune (R-SD), as well as Reps. Richard Neal (D-MA), Gabe Amo (D-RI) and Jodey Arrington (R-TX).
TELEHEALTH PROPONENTS' POLICY PRIORITIES
ATA Action members divided themselves into five groups, each focused on a different policy area.
The first policy focus is making Medicare telehealth flexibilities and the Acute Hospital Care at Home program permanent. The flexibilities include eliminating geographic restrictions and expanding originating sites for telehealth services, allowing rural health clinics and federally qualified health centers to continue to offer telehealth and enabling coverage for audio-only telehealth.
Telehealth continues to enjoy strong bipartisan support, and no one wants to see these flexibilities lapse.
Jamie Threatt, DNPTelehealth program director, LocumTenens.com
The next focus area is establishing a benefit category for prescription digital therapeutics (PDTs) in Medicare and Medicaid.
According to Anand Iyer, PhD, chief AI officer at digital therapeutics company Welldoc, the request to ensure expanded access to telehealth is preserved and create a benefits category for digital therapeutics goes hand in hand.
"Accessibility and the need for accessible healthcare is solved by telemedicine," said Iyer, an ATA Action member who met with lawmakers on Hill Day. "What would've otherwise been a face-to-face visit with your healthcare provider is now facilitated with technology. Wonderful. But the second question -- which is where the digital therapeutics and digital health component comes in -- is what do you do in between those visits?"
Digital therapeutics and digital health apps allow clinicians to track key patient care metrics between clinic visits, giving clinicians a comprehensive view of the patient's condition. Iyer noted that this enables more efficient and higher-quality care.
The final policy focus is expanding access to 'virtual foodcare.' The ATA recently launched an advocacy group to develop policies that connect virtual care with food and nutritional support.
According to Jason Langheier, MD, founder, board director and chief science officer, and Melissa Isavoran, vice president of network strategy and policy at telehealth nutrition solution Foodsmart, the foodcare advocacy group's long-term focus is passing a bipartisan Foodcare Act. Its short-term goals include expanding access to medical nutrition therapy to key patients, such as cancer patients.
RESPONSES FROM LAWMAKERS
All the ATA Action members interviewed for this piece underscored the widespread support for the policy priorities noted above.
In particular, lawmakers assured the advocacy group that the Medicare telehealth flexibilities would continue.
"Telehealth continues to enjoy strong bipartisan support, and no one wants to see these flexibilities lapse," said Hill Day participant Jamie Threatt, DNP, telehealth program director at LocumTenens.com, a healthcare recruitment agency. "Multiple offices emphasized that telehealth remains a top priority for their constituents. While we did not receive firm commitments on the duration of a potential extension, we were reassured that the current provisions would not be allowed to expire without action."
Iyer added that this sentiment was bipartisan, with both Democrats and Republicans backing the issue.
I think we're on the road to permanency, perhaps after a few more extensions.
Kyle ZebleySenior vice president of public policy, ATA and executive director, ATA Action
However, lawmakers did bring up one of the most pervasive concerns about expanded virtual care access: cost.
Lawmakers "are always looking to understand the cost implications of new policy," said Iman Ahmed, senior director of digital therapeutics commercialization at Otsuka Precision Health, a PDT provider.
With virtual care, it can be challenging to estimate those cost implications. Ahmed noted that telehealth, remote patient monitoring and digital therapeutics can significantly boost preventive care efforts, but those cost savings are not usually realized immediately. Rather, they have a downstream impact on the healthcare system overall.
Ahmed and her fellow ATA members cited independent evaluations of digital health tools conducted by the Peterson Health Technology Institute to help lawmakers understand the impact of virtual care tools. Iyer echoed this strategy, noting that ATA Action members emphasized current data to lawmakers, which shows "costs are coming down and the value is going up."
Still, there is a trove of evidence backing the myriad benefits that virtual care solutions can provide. Thus, even though lawmakers appeared to only promise another extension, ATA Action members believe that permanency is not too far in the future.
"I think we're on the road to permanency, perhaps after a few more extensions, and we've got to stay optimistic and relentless in order to continue to do all we can to maximize our impact," Zebley said.
Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.
