Cures 2.0 Bill Introduced in House Aims to Expand Telehealth Coverage

U.S. Representatives Diana DeGette (D-CO) and Fred Upton (R-MI) have introduced their finalized Cures 2.0 bill in the House which aims to expand access to telehealth for Medicare and Medicaid beneficiaries.

The 173-page bill includes policies to expedite the delivery of cures, treatments, and innovations to patients across the country.

The lawmakers first released the Cures 2.0 legislation draft in June, which included telehealth provisions that reflected the uptick in virtual care during the pandemic.

Specifically, the bill targets CMS and how the agency should extend telehealth access and coverage to Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) beneficiaries. A section-by-section summary of the bill outlined the proposed telehealth guidelines.

One of the policies is the Telehealth Improvement for Kids’ Essential Services (TIKES) Act which would help states integrate telehealth into their Medicaid program and CHIP, review the impact of telehealth on patient health, and encourage collaboration.

The bill also aims to expand Medicare telehealth flexibilities with the Telehealth Modernization Act. This policy would eliminate Medicare’s geographic and originating site restrictions that require patients to live in rural areas and be present at a doctor’s office or clinic to access telehealth services.

Further, the act would give the HHS secretary the power to expand the list of healthcare providers who can offer telehealth services and receive Medicare reimbursement for them.

Another key feature of the bill is the Ensuring Patient Access to Critical Breakthrough Products Act that would codify the CMS Medicare Coverage of Innovative Technology policies. This comes just a few days after the agency rescinded the policies, which aim to expedite the Medicare coverage process for breakthrough devices.

Additionally, the Cures 2.0 legislation would require a report from the Government Accountability Office with recommendations to enhance Medicare coverage and reimbursement for innovative health technologies.

The bill also would require a report from the HHS secretary that speaks to the viability of establishing alternative coverage pathways for innovative technologies.

The main goal of Cures 2.0 is to establish the Advanced Research Projects Agency for Health (ARPA-H) to develop treatments and cures for diseases such as diabetes, cancer, Alzheimer’s, and ALS. The legislation would authorize $6.5 billion to operate the agency for the first three years.

The representatives hope to address the COVID-19 pandemic with Cures 2.0 as well. The bill would call for HHS to conduct a nationwide study on the implications of long COVID and develop a testing and vaccine distribution strategy that could be used for future pandemics.

The legislation is a follow-up bill to the 21st Century Cures Act passed in 2016. The original bill called on CMS and the Medicare Payment Advisory Commission (MedPAC) to study how telehealth use could benefit Medicare, Medicaid, and dual-eligible beneficiaries.

Policymakers and stakeholders have recently sought to expand Medicare coverage and reimbursement for telehealth services beyond the public health emergency.

A group of senators recently introduced a bipartisan bill to solidify Medicare reimbursement eligibility for physical and occupational therapists, speech-language pathologists, and audiologists.

Additionally, a handful of telehealth advocates, including the American Telemedicine Association, the Alliance for Connected Care, and the American Medical Association, penned a letter to CMS asking the agency to amend the proposed 2022 Physician Fee Schedule and eliminate geographic and originating site restrictions.

CMS partially acquiesced and eliminated geographic barriers for telehealth use for behavioral healthcare services in the final 2022 Physician Fee Schedule released in November. The rule also stated that Medicare will cover audio-only telemental health services provided by rural health clinics and federally qualified health centers beyond the public health emergency.