Telehealth Fix Takes Step Forward in Senate
Nathan Baugh, Emma Finerfrock
On Thursday, June 18th, the Improving Telehealth for Underserved Communities Act was introduced in the Senate by Sen. Cindy Hyde-Smith (R-MS) and Sen. Angus King (I-ME).
“Thanks to the leadership of Sen. Hyde-Smith and Sen. King, the RHC community is one step closer to fixing our telehealth reimbursement issues” said Bill Finerfrock, Executive Director of the National Association of Rural Health Clinics.
The Coronavirus Aid, Relief, and Economic Security (CARES) Act allowed RHCs and FQHCs to provide telehealth services for Medicare patients as distant site providers. However, rather than reimbursing RHCs and FQHCs through their normal reimbursement mechanisms, the CARES act mandated that the Centers for Medicare and Medicaid Services (CMS) create a brand-new reimbursement methodology for RHCs and FQHCs just for their distant site telehealth services.
In April, CMS finally formalized the following highly problematic policy:
- RHCs and FQHCs receive a flat payment of $92.03 no matter what service was provided.
- RHCs and FQHCs bill all telehealth visits under one generic code (G2025) rather than reporting the proper HCPCS code, making it impossible for Medicare to properly track what types of services were provided via telehealth.
- RHCs and FQHCs must “carve out” costs and visits associated with telehealth from their annual cost reports.
The Improving Telehealth for Underserved Communities Act fixes these issues. If signed into law, the telehealth policy would be as follows:
- RHCs and FQHCs would be reimbursed through their normal mechanisms (an All-Inclusive Rate for RHCs and a Prospective Payment System for FQHCs), creating parity between telehealth and in-person visits.
- Accurate HCPCS coding would be used when billing for telehealth. This means that normal coding for 238 different services will be used for claims.
- Costs and visits associated with distant site telehealth services will be included on annual cost reports, reducing the administrative burdens currently faced.
These changes will ease the financial and administrative strains on RHCs and FQHCs and encourage providers to continue the use of telehealth to serve patients.
It is vital that RHCs contact their Members of Congress and advocate for this legislation. Your support could ensure that this legislation is included in the next COVID-19 relief package.
“Members of Congress are sensitive to their constituents’ concerns,” Finerfrock explains, “one or two rural health clinics reaching out to a Member of Congress will go a long way towards elevating the issue on their list of priorities.”
Contact information for Members of Congress can be found here. Please call your Senators and ask them to support S. 3998!
If you need any help with your advocacy efforts, please feel free to send an email to me (Nathan.Baugh@narhc.org) and we will help you with email contacts and messaging.