AHA Urges Congress to Permanently Expand Access to Telehealth Services

Amid the ongoing Congressional efforts surrounding permanent telehealth reform, the American Hospital Association (AHA) wrote letters to the US Senate and House of Representatives providing feedback on the CONNECT for Health Act and noting its support for the continuation of various telehealth flexibilities.

As the COVID-19 pandemic became increasingly severe in 2020, the government prioritized sustaining access to healthcare. It did this by removing barriers that prohibited the use of virtual care in certain circumstances, significantly widening access for patients and providers.

Since then, Congress has maintained many of the flexibilities through the Consolidated Appropriations Act passed in December 2022. Although this legislation extended various telehealth flexibilities through 2024, AHA requests that certain provisions be made permanent.

These include permanently eliminating geographic and originating site restrictions, in-person visit requirements for telemental healthcare, and site restrictions on federally qualified health centers and rural health clinics. The AHA also supports provisions that maintain telehealth reimbursement on par with in-person care and ensure coverage for audio-only telehealth.

Additional requests include expansions of eligible telehealth provider types, the removal of licensure barriers, clarification by the Drug Enforcement Administration (DEA) regarding the special registration process for administering controlled substances via telehealth, and expanded collaborative efforts on digital infrastructure and literacy initiatives.

Further, since the introduction of the original Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) Act in 2015, the virtual care arena has changed significantly, according to the letter.

"For example, providers and patients have learned first-hand about application and benefits of technology in care delivery, and use of virtual care modalities is seen now as an expectation for many beneficiaries," the letter states.

Thus, the letter encouraged bill sponsors to consider the factors that enabled the wider adoption and use of telehealth during the pandemic as they create new legislation.

In the letter, the AHA also noted that it was writing on behalf of all its 5,000 member hospitals, health systems, clinicians, and healthcare leaders. The letter acknowledged the actions that the federal government took to promote healthcare access at the beginning of the pandemic, along with the uptake of telehealth that occurred as a result.

"These swift actions provided hospitals and health systems with critical flexibilities to care for patients during what has been a prolonged and unpredictable pandemic," the letter states.

This is not the first time the AHA requested that telehealth coverage and flexibilities be solidified. 

For example, in December 2022, the AHA asked the DEA for information related to future telehealth regulations for prescribing controlled substances. In the letter, the AHA also noted the benefits of telehealth showcased throughout the pandemic, such as enabling prescriptions of controlled substances to occur through telehealth, thereby expanding access to treatment.

The letter asked that the DEA provide healthcare organizations with information on proposed rules for the special registration for telemedicine process to waive the in-person requirement for initiating controlled substance prescriptions virtually.

The letter also noted concerns that the conclusion of the public health emergency declaration before the special registration was outlined would leave providers in a position where they would not be able to offer treatment.