Insurance Coverage for Telemedicine
Insurance Coverage for Telemedicine
Why this petition matters
Chris Nalberczinski started this petition to Senator Tim Kaine and 22 others
Speech, Occupational, and Behavioral therapy services provide improved quality of life for adults and children, particularly those with special needs or who are at-risk. Removing barriers to these services is critical in helping those with special needs improve functional and developmental abilities.
Since the COVID-19 crisis, CMS and private insurance companies have altered their policies to allow providers to continue delivering services to patients via telemedicine. The use of this technology has enabled healthcare professionals to continue supporting those with special needs and their families throughout this crisis, and in many cases has actually improved the quality of care patients were already receiving. In addition to reducing potential exposure to and spread of COVID-19, influenza, and other communicable ailments, telemedicine allows patients to more effectively work with their providers from the comfort of their home while also eliminating travel time and associated environmental impacts. Telemedicine is effective and removes many of the barriers and risks involved with traditional direct in-person healthcare.
In order to comply with state/local health department, OSHA, and CDC guidelines, upon reopening, providers and patients will be required to wear PPE including masks and face shields, presenting an additional barrier to administering therapeutic services. Let me be clear; one cannot perform effective therapeutic intervention while wearing a mask. The nature of having to see lips, mouths, tongues, and facial expressions is inherently paramount in delivering these types of therapeutic services. Doing so with PPE is effectively impossible. Furthermore, certain patients, depending on their disability, may not even be able to wear PPE. Additionally, the overwhelming expense and time involved in properly administering PPE will quickly drive small healthcare practices out of business.
American Speech-Language-Hearing Association (ASHA) has supported teletherapy since 2005. Online speech therapy has been found effective by over 50 published, peer-reviewed studies, beginning with a landmark paper by the Mayo Clinic in 1997. This is evidence based practice. Telemedicine technology has the potential to greatly improve the way we administer therapy in the post-COVID world. For a vast majority of health services - particularly outpatient therapy - telemedicine just makes sense, and in most cases, is the only responsible way providers can continue delivering services in this COVID-19 climate.
CMS has moved to extend coverage of telemedicine services through the end of June. This is a good step, but it’s not enough. This petition calls for mandates to Medicaid/Medicare and private health insurance companies to extend industry-wide coverage for primary and secondary telemedicine services now and indefinitely into the future, implementing parity with payment and documentation requirements applicable to in-person services. Services that are the same should be reimbursed at the same rate whether provided in-person or through telemedicine. Health plans should not be permitted to require additional documentation for telemedicine services beyond what the plan already requires for in-person services.
Evidence-based research has shown myriad benefits and almost no downsides to using telemedicine. The future is here, the need is now, and common sense dictates that it’s time for insurers to cover telemedicine services - doing so can save lives, save money, and it's a change we can all benefit from.