New Bill Seeks to Improve Medicaid, CHIP Telehealth Coverage for Kids

A new bill before Congress aims to improve telehealth coverage for children through state Medicaid and Children’s Health Insurance Program (CHIP) services.

The Telehealth Improvement for Kids’ Essential Services (TIKES) Act of 2020, introduced this week by US Reps. Lisa Blunt Rochester (D-DE) and Michael Burgess, MD (R-TX), would “provide guidance and strategies” to help states integrate telehealth in Medicaid and CHIP programs and mandate telehealth studies from both the Government Accountability Office (GAO) and the Medicaid and CHIP Payment and Access Commission (MACPAC).

“The COVID-19 pandemic has allowed for us to make rapid progress on expanding access to telehealth so children and families across the country, especially those in rural and underserved communities, face fewer barriers to accessing medical care,” Rochester said in a press release. “With the introduction of the TIKES Act, we can continue that progress by bringing better alignment and clarity to Medicaid telehealth policies, as well as provide guidance to state Medicaid programs on the opportunities telehealth services can have for children.”

“Amidst the pain and suffering that our nation has endured throughout the COVID-19 pandemic, a major takeaway has been the advantage of telehealth,” added Burgess. “There is a convenience factor to not having to take time to physically transport yourself to the doctor’s office and have your child sit in a waiting room with other potentially sick patients. This bipartisan legislation will improve utilization of telehealth by requiring the Centers for Medicare and Medicaid Services (CMS) to provide guidance to states on how to make the most of telehealth options in their Medicaid and CHIP programs. Additionally, it directs studies to gather data that can help inform future telehealth policy.”

The legislation would build upon a 25-page toolkit unveiled in April by CMS that’s designed to help states expand telehealth coverage under Medicaid and CHIP to deal with the pandemic.

Among those supporting the bill is the Nemours Children’s Health System, which operates hospitals in Delaware and Florida and an extensive connected health platform serving patient and providers across the country.

“While providers across the country have taken swift action to ramp up telehealth capacity during the COVID-19 pandemic, we need long-term solutions to reduce barriers to provide safe and reliable care via telehealth,” Carey Officer, operational vice president of Nemours Center Health Delivery Innovation (CHDI), said in a separate release. “Introduction of the TIKES Act is an important step forward.”

Specifically, the bill calls on the Health and Human Services Department to provide guidance – in best practices and technical assistance – to states for integrating telehealth into their Medicaid and CHIP programs.

It also directs MACPAC to complete a study of telehealth services in at least 10 states, addressing access, cost, outcomes and utilization; and it directs the GAO to study how federal agencies have collaborated to improve telehealth coverage in Medicaid and CHIP programs, including early care and education settings.