COVID-19: AAN Urges Feds to Further Expand Telehealth Benefits

Megan Brooks

March 23, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's  Coronavirus Resource Center.

In the face of the COVID-19 pandemic, the American Academy of Neurology (AAN) is calling on the federal government to do more to expand telehealth services beyond Medicare.

As reported by Medscape Medical News, last week the Trump administration announced an expansion of telehealth benefits to help stop the spread of COVID-19 and allow more Medicare patients to receive virtual care without having to visit a healthcare center or physician office. 

Under the expansion, Medicare will pay for office, hospital, and other visits furnished via telehealth across the country and including in the patient's home, delivered by a range of providers, such as physicians, nurse practitioners, clinical psychologists, and licensed clinical social workers.

Prior to this waiver, Medicare would only pay for telehealth on a limited basis, such as when the patient receiving the service was in a designated rural area.

However, in a letter to Alex Azar, Secretary of the US Department of Health & Human Services (HHS), the AAN says the easing of restrictions on telehealth should be extended beyond Medicare fee-for-service to both Medicare Advantage and Medicaid patients.

Practice Changing?

"It is very heartening that the government is stepping up to the plate" and lifting many telemedicine restrictions, Neil Busis, MD, member of the AAN Health Policy Subcommittee, told Medscape Medical News.

Busis, who leads the telemedicine program for the department of neurology at NYU Langone Health in New York City, said the global pandemic has "heightened, focused, and sharpened" attention to the need for telehealth services, particularly for neurology.

"By definition, a lot of neurology patients have mobility problems, traveling is a burden, making it difficult to see a neurologist," he said.

Busis hopes these waivers in telehealth, made on a temporary and emergency basis, will become permanent once the COVID-19 pandemic has passed.

"What we hope is that the usefulness of various virtual technologies tested in the crucible of this pandemic will stimulate people to think about it once the pandemic is over and not rescind these loosening of restrictions, and that this will be the beginning of a new era for telemedicine," he said.

The COVID-19 pandemic may be a "catalyst to accelerate the incorporation of non-face-to-face care into our armamentarium," he added.

"What we have discovered in recent years is non-face-to-face care with enabling communication technologies is as effective in many clinical situations as face-to-face care. Now is the time to really focus on making the virtual experience as good as possible and to make it as available to as many people as possible," said Busis.

Reduce Regulatory Burdens

The AAN also calls on the federal government to urge states to take action to ensure access to telehealth services and allow telehealth companies to provide telehealth technology and education free of charge to providers who don't currently use telehealth in their practices.

"The AAN notes that doing so may implicate provisions of the Anti-Kickback Statute. We believe during the current emergency that HHS should issue guidance making it clear to providers that accepting free access to telehealth platforms and education does not put them at risk of violating fraud and abuse laws," the letter signed by AAN President James Stevens, MD, states.

The AAN also wants the government to reduce regulatory burdens during this public health emergency to allow physicians more time to focus on patient care. "This is especially true for providers that are self-quarantining or are in a practice that is experiencing staffing shortages due to self-quarantines," he writes.

Specifically, the AAN asked the Centers for Medicare & Medicaid Services (CMS) to extend the March 31 deadline for physicians to submit their data for the Merit-based Incentive Payment System program for calendar year 2019 (and other compliance deadlines) by at least 30 days.

The AAN also calls on CMS to delay implementation of the Appropriate Use Criteria program by 1 year, saying that many providers will not have the capacity to "meaningfully" participate in the current testing year for the program.

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