Telehealth Task Force Announces Policy Change Recommendations

A task force comprised of some of the biggest names in telehealth advocacy has issued a report calling for permanent changes to telehealth coverage beyond the coronavirus pandemic.

The Taskforce on Telehealth Policy, launched in June by the American Telemedicine Association, Alliance for Connected Care and National Committee for Quality Assurance, unveiled the report this week as pressure ramps up on the federal government and Congress to keep certain connected health policies in place after the public health emergency ends.

"This report sets the stage for the clear, decisive action from policymakers," ACC Executive Director Krista Drobac said in a press release issued after the Tuesday afternoon event. “While there is a need for continued data collection and thoughtful regulation, this report demonstrates that both patients and clinicians agree that remote care options should remain available after the public health emergency comes to an end."

In its report, the task force argues that many of the restrictions on telehealth coverage and use were put in place when the technology was unproven, and there were questions about cost, value and overuse. But the surge in use of connected health services and tools to deal with the coronavirus pandemic has given the healthcare industry – and its regulators – plenty of data on how the technology can and should be used.

To that end, the task force urges policymakers to make several changes:

• “Removal of strict limits on sites where telehealth visits may originate, conditions clinicians may treat, and which clinicians and providers may use telehealth;
• Acknowledging that telehealth visits can establish clinician/patient relationships as long as they meet appropriate standards of care or unless careful analysis demonstrates that, in specific situations, ensuring patient safety, program integrity or appropriate high-quality care requires a previous in-person relationship;
• Allowing audio-only telehealth where evidence demonstrates it to be effective, safe and appropriate, or where it is likely to be so and offers access to care that would otherwise be unavailable to a patient;
• Allowing asynchronous telehealth (e.g., remote patient monitoring) when it is the preference or need of the patient on a limited basis as more clinical evidence is generated on best practices for ensuring quality, safety and program integrity;
• Identifying and implementing policies related to use of these modalities that is based on the evidence of their effectiveness, safety and ability to meaningfully impact access to care;
• Allowing insurers to provide telehealth technology, such as smartphones and tablets, as supplemental benefits; and
• Allowing telehealth across state lines by considering strategies to expedite licensure reciprocity between states, while maintaining important patient protections and disciplinary tools for bad actors.”

In addition, the task force recommends that stakeholders agree on a “taxonomy of telehealth” that describes the full range of services and modalities that meet requirements for standards, quality and, where appropriate, cost. Within that framework, virtual visits should be viewed as a separate site of care, rather than a different type of care.

The task force also asks lawmakers to “look closely at the effect of expanding prescribing authority to telehealth,” a key factor in the development of telehealth and mHealth programs for behavioral and substance abuse treatment, such as medication assisted treatment (MAT) therapy.

As well, the task force urges policymakers to expand efforts to ensure universal access to telehealth through broadband connectivity, assess how telehealth can address patients who face barriers due to language or speech or hearing issues, and set contingency plans for when the technology fails.

It also puts emphasis on initiatives to address digital literacy gaps and the public’s lack of trust in the technology.

Finally, the task force urges lawmakers to fully reinstate the Health Insurance Portability and Accountability Act (HIPAA), which has been waived during the pandemic to allow care providers and patients to use a wider variety of platforms to communicate.

In analyzing how telehealth should be expanded to meet the demands of a post-COVID-19 landscape, the task force focused on three topics: patient safety and program integrity; data flow, care coordination and quality measurement; and effect on total cost of care. The report includes several recommendation in each category.

“These recommendations were developed through broad consensus and clearly seek to establish telehealth as a permanent modality,” ATA CEO Ann Mond Johnson said in a press release. “We heard loud and clear from a range of stakeholders that virtual care must remain an option for patients and providers after the public health emergency is over. Our recommendations provide guidance on aligning standards, quality, payment, and program integrity to make telehealth available to all, including those in underserved and rural communities and our most vulnerable patient populations.”