House representatives from both sides of the aisle have introduced legislation that would help ensure Medicare Advantage (MA) members who cannot access the video component during telehealth visits are able to access care through audio visits during the COVID-19 pandemic.
Although the Centers for Medicare and Medicaid Services has provided flexibility to allow health care providers to offer telehealth services under MA plans, it requires that the encounters include a video component, which is not an option for many patients. Low-income and rural patients for example, may have trouble accessing technology or broadband services supporting video communications. Additionally, seniors or at-risk populations may have physical limitations that prevent them from using video communications. For these patients, an audio-only telehealth visit may be the only option besides foregoing needed care.
The Ensuring Parity in MA and PACE for Audio-Only Telehealth Act will allow providers to offer audio-only telehealth services to MA enrollees, providing them with the resources necessary to adequately care for their patients. The legislation would also ensure that providers will be adequately compensated by requiring MA plans to reimburse them for audio-only telehealth visits as if they were in person visits unless both parties have agreed to a separate payment policy.
The bill was introduced this week by US Reps. Terri Sewell (D-Ala), Rep. Gus Bilirakis (R-Fla. ), Tony Cárdenas (D-Calif. ), Brian Fitzpatrick (R-Pa.), Chrissy Houlahan (D-Pa.), Ron Kind (D-Wisc. ), Jason Smith (R-Mo.) and Jackie Walorski (R-Ind.). The bill has the support of the Better Medicare Alliance and America’s Health Insurance Plans (AHIP), which noted the bill would allow for audio-only telehealth services to count toward MA risk adjustment.
“Telehealth delivered by phone has been a lifeline to many seniors and people with disabilities throughout the COVID-19 crisis, either because they don’t have Internet access or because they don’t have or aren’t comfortable with video technology. This bill will ensure that Medicare enrollees are not left behind, whether they live in rural or urban settings. We applaud these Representatives for introducing this important legislation to improve health equity and ensure America’s seniors and people with disabilities have access to the care they need, when they need it, in a way that is safe and convenient for them,” AHIP CEO Matt Eyles said in an announcement.
In a separate statement, Allyson Y. Schwartz, president and CEO of Better Medicare Alliance, said that in-person physician office visits dropped precipitously during the pandemic and many seniors lack the tools to complete an audio-video telehealth appointment. "Medicare Advantage must be equipped to meet beneficiaries where they are by allowing access to care through a simple phone call where appropriate or when beneficiaries lack other technological means. In addition, it is critical that information on health conditions and diagnoses that are obtained via audio-only telehealth be allowed to count for risk adjustment purposes," she said.
Sewell also said in a statement that the bill would allow MA members to access audio as well as video telehealth services to ensure they don’t forego critical care during the pandemic, particularly seniors who live in rural areas without access to broadband speeds that support video connections.