Telehealth stakeholders say permanent telehealth legislation is needed to remedy patients' and providers' confusion over the patchwork of telehealth services created by CMS' 2023 Medicare physician fee schedule out this week.
CMS' rule creates a mishmash of telehealth policies: Some pandemic flexibilities are set to expire after the COVID-19 public health emergency and subsequent 151-day extension, and some will be covered temporarily until the end of 2023 if the PHE ends before the end of the year.
Brett Meeks, vice president at Horizon Government Affairs said patients aren't scheduling remote visits anymore at some doctors' offices because they're not sure their payer will cover it. Doctors are supposed to be providing care for patients in a way that is most efficient and accessible for both them and the patient, which is sometimes remote care.
Meeks said providers are not paid to navigate CMS regulations.
"That 151-day timeline is a direct product of how much money Congress could get out of the offsets that we're using under the rules of passing legislation," Meeks said. "It's just all of this sort of DC crap is making it confusing for patients and doctors to know what tools they can use."
Meeks said that workforce shortages are also a concern for providers while Medicare makes continual cuts to provider payments. Doctors are burning out and industry professionals are struggling to hire nurses, which will be exacerbated by payment cuts, according to Meeks.
The schedule seems to show that CMS is moving away from some telehealth provisions, like audio-only telehealth, while Congress and others seem to be leaning into the flexibilities, according to Meeks.
"It always changes the way we have to talk about things to convince people that telehealth is worth investing in and worth passing legislation on," Meeks said. "Because if CMS does one thing or another, depending on the party or office you're talking to, you have to defend yourself and say why CMS got it wrong."