Stakeholders Request Telehealth Coverage Extension for HDHPs

A letter that the Connected Health Initiative (CHI) addressed to the leaders of the US Senate and House of Representatives requested that Congress extend the safe harbor for telehealth coverage by high-deductible health plans (HDHPs) alongside Medicare telehealth flexibilities.

The CHI is a multistakeholder initiative of ACT | The App Association driven by its steering committee, which includes the American Medical Association, Microsoft, Apple, George Washington University Hospital, GoodRx, and UnitedHealth Group.

During the COVID-19 pandemic, it became evident that telehealth offers a long list of benefits for patients with various conditions. For example, in October, researchers from the Perelman School of Medicine at the University of Pennsylvania created a virtual care program to promote fertility care access.

The flexibilities implemented during the pandemic that spurred telehealth use are intended to be temporary. But, as the benefits associated with telehealth and its popularity among patients and providers become increasingly apparent, many healthcare organizations are urging the federal government to make that expanded telehealth access permanent.

In its letter sent earlier this week, CHI noted its support for removing restrictions that impede telehealth access among Medicare beneficiaries and highlighted the telehealth deadline American beneficiaries with HDHPs face at the end of 2022.

The deadline refers to the expiration of the statutory allowance for first-dollar coverage of telehealth by HDHP plans, along with “other remote care services.” This led CHI to request that Congress separately extend the safe harbor for HDHPs to cover telehealth with first-dollar coverage, which would allow them to maintain HDHP status.

Additional requests in the letter include asking Congress to clarify what constitutes “other remote care services,” as well as an extension of the HDHP safe harbor for two years.

The letter also detailed the rapid uptake of telehealth and the many patients that turned to this form of care because of the COVID-19 pandemic. In the summer and fall of 2020, telehealth usage accounted for over 30 percent of visits at Health Resources and Services Administration-funded centers. Before the pandemic, this number was close to zero.

Thus, it is essential to extend the safe harbor for telehealth coverage by HDHPs before it expires.

"If Congress does not act before this deadline, coverage of services furnished using basic, widely available live audio and video technology will be as limited as it was before the pandemic, a disaster scenario for American patients and caregivers," the letter states. "Ensuring that Americans can continue to access virtual services is crucial to maintaining and expanding access to care for Americans, whether they are Medicare or HDHP beneficiaries."

Congress has previously made efforts to support expanded telehealth coverage. For example, the omnibus spending bill passed in March included provisions to extend telehealth flexibilities for Medicare beneficiaries. Specifically, the bill extended telehealth waivers enacted during the COVID-19 pandemic for at least five months following the expiration of the public health emergency.

The telehealth waivers include the removal of geographic requirements for telehealth coverage, expanding originating sites for telehealth services, and widening the list of providers who can offer telehealth services.