In early February, two senators introduced the Telehealth Extension and Evaluation Act to extend Medicare telehealth reimbursement waivers another 2 years following the end of the public health emergency declared due to the COVID pandemic. It would also extend DEA prescribing waivers for another 2 years. Under this bill, reimbursement for telehealth services would continue. It would also continue coverage for patients with high deductible plans, rural hospitals, and others.
While this bill is a needed law in our current times, it stops short on many fronts. We all know the high infectivity rate of COVID and the need to practice physical distancing. In a typical medical practice, there are many immunocompromised patients in close proximity to those who may have various infections. Such a close contact can quite literally kill them. Telehealth is a great tool to keep sick patients home and treated through telemedicine, while at the same time protecting those who are at higher risk. This is certainly true for COVID, but it holds true for other infections as well. Patients often say they are just too sick to come into the office. Often, it is quite simple to triage them via telemedicine.
When the pandemic ends, the need for telemedicine will not. We have all seen the benefits. From the mother who has to bundle up all her kids in the cold weather to bring along with her to her doctor’s visit, to the daughter who has an elderly mother in a different state, there are so many people who can get quality care through the use of telemedicine. It is also less expensive to administer. Telehealth should indeed be extended, but not for 2 years; it should become a permanent part of the healthcare landscape.
Why the Bill Falls Short
- It doesn’t recognize the value of telehealth as a tool outside of the current pandemic.
- It defines a narrow scope of who may benefit from these services. Often, patients don’t get medical care because they just don’t have time. Telehealth opens a whole new opportunity for the time-crunched.
- It gives an extension of 2 years beyond the end of the pandemic (ie, 2024). Yet, no one really knows when the pandemic will end. We’re just one variant away from a complete start over.
- It fails to acknowledge the provisions that physicians have made in their practices to incorporate telehealth. Some have spent money for new software. Also, patients have now come to rely on these services. Why take away something that is working? Schedules have been adapted to balance telehealth with in-person visits.
- It neglects the primary care physician shortage that we are facing. Telehealth enables us to treat more patients in a given time. There are crucial shortages of physicians in many areas and telehealth allows us to fill those gaps.
Should the Telehehealth Extension and Evaluation Act Be Passed?
Yes, but it should widen its scope to include all patients and have no deadline. Technology is advancing, not going backward, and the medical profession tries to stay on the front of that innovation. We have found that telehealth is of great utility in our clinical practices and benefits many people. It can never replace in-person visits, but we now see where it works. However, doctors cannot be expected to provide these services for free. Insurance companies should cover these at fair and reasonable reimbursement rates. If we need a law to make that happen, it should be passed. Patients who would have never consulted a physician or who could potentially expose another person to a deadly infection can now be treated easily outside of the office. Patients deserve our best care and telehealth is often the best medical treatment we can give them.
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