November 10, 2020

MedPAC Discusses Expansion of Telehealth in Medicare

On Nov. 9, the Medicare Payment Advisory Commission (MedPAC) met to discuss expansion of telehealth in Medicare and possible policy options following the end of the COVID-19 public health emergency (PHE). During the PHE, the Centers for Medicare and Medicaid Services (CMS) has given providers broad access to telehealth services, but upon expiration of the PHE, which is currently extended to Jan. 21, 2021, these regulations are set to end.

MedPAC staff explained that even before the PHE, there was a growing interest in expanding telehealth coverage. However, others contend that telehealth services have the potential to increase use and spending under the Medicare fee-for-service payment system.

MedPAC staff detailed telehealth policies before the COVID-19 PHE, policies during the PHE, and possible policy options post-PHE. Telehealth policy options post-PHE provided by MedPAC staff included:

  • Expansion of Medicare beneficiaries covered;
  • Coverage of many but not all of the telehealth services paid for during the PHE;
  • Elimination of temporary coverage of audio-only services after the PHE;
  • Lower rates for telehealth services than for in-person services;
  • HIPAA compliance for telehealth technology, cost sharing for telehealth services; and
  • Other safeguards to protect Medicare and beneficiaries from unnecessary spending and potential fraud.

There was general support from Commissioners for these policy options presented by staff, however, agreement was not universal. Particularly, there was division on the topic of audio-only visits, with a lot of support from Commissioners for maintaining audio-only visits to address access to care and equity concerns.

The MedPAC will continue its discussion on telehealth expansion in future meetings.