Senators Again Seek Telehealth Waivers for Home Healthcare Providers

Lawmakers are re-introducing a bill aimed at extending Medicare coverage for home health services delivered by telehealth during a public health emergency.

S. 1309, introduced on April 22 by US Senators Susan Collins (R-ME), Jeanne Shaheen (D-NH), Roger Marshall (R-KS) and Ben Cardin (D-MD), reportedly mirrors the Home Health Emergency Access to Telehealth (HEAT) Act, which was submitted in 2020 by Collins and Cardin but failed to make it out of the Senate.

The newest iteration of the bill would give the Centers for Medicare & Medicaid Services the authority to issue waivers for home healthcare services delivered by telehealth to replace in-person visits during a public health emergency. It would help home healthcare providers improve access to care and reach more patients in need, while reducing potential exposure during a pandemic.

As with last year’s bill, it would expand telehealth coverage during a public health emergency for home health services via “visual or audio telecommunication systems.” The use of telehealth must be deemed appropriate, must be approved by the beneficiary prior to use, and would be reimbursed only if those telehealth visits don’t make up more than half of all billable visits during a 30-day payment period.

The bill has the strong support of those in the home healthcare community, who have been lobbying for more access to and coverage of connected health tools and platforms long before COVID-19 even became a thing.

“The COVID-19 pandemic has firmly demonstrated the value of telehealth as a tool in meeting the clinical needs of home health patients,” William Dombi, president of the National Association for Home Care & Hospice (NAHC), recently told Home Health Care News. “However, with the absence of any reimbursement for telehealth, home health agencies have not had the ability to make full use of it.”

CMS currently does not recognize the home health care provider as a telehealth provider – instead, it allows primary care providers to prescribe telehealth services in the home, and manages the services provided by home health care companies. In other words, doctors and other practitioners can prescribe and bill for telehealth services furnished, but home health care providers can’t.

In addition, telehealth visits do not count toward a home health care providers’ low-utilization payment adjustment (LUPA) threshold, which sets a minimum number of in-person visits that a care provider must complete.

The proposed legislation joins a growing number of bills focused on telehealth expansion and access now before Congress. Last year’s Congress did little to address the issue, putting more pressure on this year’s version to act on some of these bills and develop some sort of long-term policy that addresses connected health.