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340 ORGANIZATIONS SEND LETTER TO CONGRESS URGING ACTION ON TELEHEALTH

June 29, 2020 

The Honorable Mitch McConnell 

Majority Leader 

United States Senate 

Washington, DC 20510 

The Honorable Charles Schumer 

Minority Leader 

United States Senate 

Washington, DC 20510 

The Honorable Nancy Pelosi 

Speaker 

United States House of Representatives 

Washington, DC 20515 

The Honorable Kevin McCarthy 

Minority Leader 

United States House of Representatives 

Washington, DC 20515

Dear Congressional Leaders: 

Thank you for acting to expand access to telehealth services during the COVID-19 public health emergency (PHE) by providing the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) the authority to waive longstanding restrictions on Medicare telehealth services and ensuring that additional types of health care providers can furnish telehealth services during the pandemic. 

Providers across the country have utilized these flexibilities to scale delivery and provide older Americans, many for the first time, access to high quality virtual care, resulting in 11.3 million beneficiaries accessing telehealth services in mid-April alone.1 Medicare Advantage plans have driven a similar expansion with 91 percent of seniors reporting a favorable telehealth experience and 78 percent likely to use telehealth again in the future, figures that closely track with similar patient satisfaction data from health systems nationwide.2 Additional flexibility has also allowed Federally Qualified Health Centers (FQHC) to deliver safe and effective care to underserved patient populations that have rated the service they received highly.3 

1 https://www.healthcaredive.com/news/medicare-seniors-telehealth-covid-coronavirus-cms-trump/578685/ 

2 https://www.bettermedicarealliance.org/sites/default/files/BMA%20Memo%20CT%20D2%5B3%5D.pdf 

3 https://www.himss.org/resources/providing-telehealth-visits-underserved-communities-case-study 

4 https://www.fairhealth.org/states-by-the-numbers/telehealth 

5 https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality 

Private health plans have also followed suit, and in response, telehealth adoption has soared – resulting in a 4,300 percent year-over-year increase in claims for March 2020.4 Taken as a whole, these temporary policy changes have allowed 46 percent of Americans to replace a cancelled healthcare visit with a telehealth service during the pandemic. With so many patients accessing care virtually, expectations for the future of our healthcare system have shifted significantly and 76 percent of Americans now report having a strong interest in using telehealth moving forward.5 

Driven by swift action from Congress and new patient demand, healthcare organizations are dramatically transforming and investing in new technologies to meet the needs of many Americans. Unfortunately, much of this transformation is dependent on temporary flexibilities extended to health systems and providers that are limited to the duration of the COVID-19 public health emergency declaration. Absent additional action from Congress, Medicare beneficiaries will abruptly lose access to nearly all recently expanded coverage of telehealth services when the emergency declaration ends. 

Virtual care has provided unprecedented access for patients, but it has become clear that uncertainty as to the future of telehealth under Medicare will halt or reverse further adoption and utilization – to the detriment of both patients and providers. 

Given the statutory restrictions in Section 1834(m) of the Social Security Act and that the authorities granted to HHS and CMS through recent coronavirus legislation are limited to the COVID-19 public health emergency period, Congress must act to ensure that the Secretary has the appropriate flexibility to assess, transition, and codify any of the recent COVID-19-related telehealth flexibilities and ensure telehealth is regulated the same as in-person services. Congress not only has the opportunity to finally bring the US healthcare system into the 21st century, but the responsibility to ensure that billions of dollars in COVID-focused investments made during the pandemic are not wasted and instead used to support the transformation of care delivery and ultimately, expand access to high quality virtual care to all Americans. 

With these critical issues in mind, we ask that Congress advance permanent telehealth reform focused on the following priorities: 

1. Remove Obsolete Restrictions on the Location of the Patient: Congress should permanently remove the current section 1834(m) geographic and originating site restrictions to ensure that all patients can access care at home, and other appropriate locations. The response to COVID-19 has shown the importance of making telehealth services available in rural and urban areas alike. In order to bring clarity and provide certainty to patients and providers, we strongly urge Congress to address these restrictions in statute by striking the section 1834(m) geographic limitation on originating sites and allow beneficiaries across the country to receive virtual care in their homes, or location of their choosing, where clinically appropriate and with beneficiary protections and guardrails in place. 

2. Maintain and Enhance HHS Authority to Determine Appropriate Providers and Services for Telehealth: Congress should provide the Secretary with the flexibility to expand the list of eligible practitioners who may furnish clinically appropriate telehealth services. Similarly, HHS and CMS should maintain the authority to add or remove eligible telehealth services – as supported by data and demonstrated to be safe, effective, and clinically appropriate – through a predictable regulatory process that gives patients and providers transparency and clarity. 

3. Ensure Federally Qualified Health Centers and Rural Health Clinics Can Furnish Telehealth Services after the PHE: FQHCs and RHCs provide critical services to underserved communities and have expanded telehealth services after restrictions were lifted under the CARES Act. Congress should ensure that FQHCs and RHCs can offer virtual services post-COVID and work with stakeholders to support fair and appropriate reimbursement for these key safety net providers. 

4. Make Permanent HHS Temporary Waiver Authority During Emergencies: Congress has given HHS authority under Section 1135 of the Social Security Act to waive restrictions during the COVID-19 pandemic. However, the waiver authority is specific to this particular PHE. Congress should ensure HHS and CMS can act quickly during future pandemics and natural disasters. 

We encourage you and your colleagues to consider legislation centered on these priorities before the public health emergency expires, which would end beneficiaries’ access to virtual care. These priorities ensure HHS and CMS have the necessary authority to maintain oversight of telehealth services, guaranteeing access to safe, effective, and appropriate care while targeting clearly outdated statutory 

restrictions that discriminate based on geography and patient location. Swift congressional action will provide a clear signal to patients, who are concerned about the future of their telehealth benefits, as well as providers and health systems, which are hesitant to make investments in critical healthcare infrastructure without certainty from policymakers. 

We need your support in ensuring that seniors and providers do not go over the telehealth “cliff” – losing access to these critical services when they are still needed by so many. We look forward to working with you to build on the temporary reforms included in the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 and the Coronavirus Aid, Relief, and Economic Security (CARES) Act to ensure Medicare beneficiaries can continue to access care when and where they need it. 

Sincerely, 

Adirondacks ACO 

Advanced ICU Care, Inc. 

Advanced Medical Technology Association (AdvaMed) 

Adventist Health 

Air Visits 

Allergy & Asthma Network 

Alliance for Aging Research 

Alliance for Connected Care 

Alliance of Community Health Plans 

Allscripts 

Alpha Medical 

ALS Association 

Altheia Predictive Health 

Alzheimer’s Foundation of America 

AMD Global Telemedicine 

Amen Clinics, Inc 

America Pharmacists Association 

American Academy of Allergy, Asthma & Immunology 

American Academy of Ambulatory Care Nurses 

American Academy of Audiology 

American Academy of Family Physicians 

American Academy of Hospice and Palliative Medicine 

American Academy of Neurology 

American Academy of PAs 

American Association of Colleges of Nursing 

American Association of Nurse Anesthetists 

American Association of Nurse Practitioners 

American Cancer Society Cancer Action Network 

American Chiropractic Association (ACA) 

American Clinical Neurophysiology Society 

American College of Obstetricians and Gynecologists 

American College of Physicians 

American Consumer Institute Center for Citizen Research 

American Diabetes Association 

American Geriatrics Society 

American Heart Association 

American Lung Association 

American Medical Rehabilitation Providers Association 

American Nurses Association 

American Occupational Therapy Association 

American Organization for Nursing Leadership (AONL) 

American Osteopathic Association 

American Physical Therapy Association 

American Psychoanalytic Association 

American Psychological Association 

American Society of Nephrology 

American Society of Pediatric Nephrology 

American Speech-Language-Hearing Association 

American Teledentistry Association 

American Telemedicine Association (ATA) 

American Urological Association 

Americans for Prosperity 

America’s Essential Hospitals 

AMGA 

Amwell 

Ascension 

Association for Behavioral Health and Wellness 

Association of Asian Pacific Community Health Organizations (AAPCHO) 

Association of Departments of Family Medicine 

Association of Diabetes Care & Education Specialists 

Association of Family Medicine Residency Directors 

Association of Oncology Social Work 

Association of periOperative Registered Nurses 

Association of Public Health Nurses 

athenahealth 

Avera Health 

Beacon Medical Group, Inc. 

Better Medicare Alliance 

Biofourmis, Inc. 

BioscienceLA 

BJC HealthCare 

Bright.md 

California Association of Public Hospitals and Health Systems 

California Health Information Association 

California Health Information Services & Partnership Organization 

California Primary Care Association 

California Psychological Association 

California Telehealth Policy Coalition 

CaliforniaHealth+ Advocates 

Cancer Support Community 

Caregility 

CareSpan USA, Inc. 

Center for a Free Economy 

Center for Freedom and Prosperity 

Center to Advance Palliative Care 

Centering Healthcare Institute 

Centerstone 

Central Logic 

Cerner 

Change Healthcare 

Chesapeake Urology Associates 

CHI Franciscan 

Children’s Health Fund 

Chimes International Inc 

ChristianaCare 

Clinical Informatics, Inc. 

Coalition for Compassionate Care of California 

Coalition For Headache And Migraine Patients (CHAMP) 

Cohen Veterans Network 

College of Healthcare Information Management Executives (CHIME) 

College of Psychiatric and Neurologic Pharmacists (CPNP) 

Columbia University Irving Medical Center 

CommonWell Health Alliance 

Compassion & Choices 

Connected Home Living 

Consumer Choice Center 

Consumer Technology Association 

Convenient Care Association 

Cosan Group 

CoverMyMeds 

Curve Health 

Cystic Fibrosis Foundation 

DestinyWell 

Devoted Health Inc. 

Diabetes Patient Advocacy Coalition (DPAC) 

Digital Medicine Society (DiMe) 

Digital Therapeutics Alliance (DTA) 

Doctor On Demand 

Duke Health 

eHealth Initiative 

EHR Association 

emids 

Encounter Telehealth, LLC 

Endocrine Society 

Envision Healthcare 

Epic Systems Corporation 

Epilepsy Foundation 

EveryLife Foundation for Rare Diseases 

ExamMed 

Excalibur Healthcare 

Federation of American Hospitals 

Fight Colorectal Cancer 

Foothold Technology 

Forefront Telecare, Inc 

Frederick Health 

FreedomWorks 

Friends of the National Institute of Nursing Research 

Global Partnership for Telehealth, Inc. 

GlobalMedia Group, LLC, DBA GlobalMed 

GlyCare 

GO2 Foundation for Lung Cancer 

Google 

Grace Initiative Foundation Tree 

Grapevine Health 

Greenway Health 

HCA Healthcare 

Health Data & Management Solutions (An Aetna company) 

Health Innovation Alliance 

Healthcare Leadership Council 

Heart Failure Society of America 

HIAI-TOUCH (Telehealth Outreach for Unified Community Health) Non-profit 

Hillrom 

Hims & Hers Health, Inc. 

HIMSS 

HIMSS Central Pennsylvania Chapter 

HIMSS Central/North Florida Chapter 

HIMSS Delaware Valley Chapter 

HIMSS Greater Illinois Chapter 

HIMSS Indiana Chapter 

HIMSS Kentucky Bluegrass Chapter 

HIMSS Louisiana Chapter 

HIMSS Maryland Chapter 

HIMSS Minnesota Chapter 

HIMSS Montana Chapter 

HIMSS Nebraska Chapter 

HIMSS New England Chapter 

HIMSS Northern California Chapter 

HIMSS Oregon Chapter 

HIMSS South Carolina Chapter 

HIMSS Tennessee Chapter 

HIMSS Washington Chapter 

Hospice Palliative Nurses Association 

HSA Coalition 

IHE USA 

Immune Deficiency Foundation 

IncludeHealth, Inc. 

Indiana University Health 

Indie Health 

Infectious Diseases Society of America 

Inovalon 

InSight + Regroup 

Intel Corporation 

Intermountain Healthcare 

International OCD Foundation 

InTouch Health 

K4Connect 

Keck Medicine of USC 

Lanai Community Health Center 

LeadHealth 

LeadingAge 

Leidos 

Leon Concierge Medicine 

Less Government 

Lewy Body Dementia Association 

Life365 

LifePoint Health 

LifeWIRE Corp. 

Lincare 

LiveWell Alliance, Inc. 

Livongo 

Locumtenens.com 

Marshfield Clinic Health System 

Mass General Brigham 

Massachusetts General Hospital 

Medical Group Management Association 

Medisante’ Group 

MedStar Health 

MedWand Solutions, Inc. 

Mend VIP, Inc. 

Mental Health America 

MiCare Path 

Michigan Medicine 

Muscular Dystrophy Association 

MyndYou 

NACBHDD and NARMH 

National Association for Healthcare Quality 

National Association for Home Care and Hospice 

National Association of ACOs 

National Association of Community Health Centers 

National Association of Health Underwriters 

National Association of Pediatric Nurse Practitioners 

National Association of Rural Health Clinics 

National Association of Social Workers 

National Athletic Trainers’ Association 

National Council for Behavioral Health 

National Council of State Boards of Nursing 

National Diabetes Volunteer Leadership Council 

National League for Nursing 

National Nurse-Led Care Consortium 

National Organization for Rare Disorders 

National Partnership for Healthcare and Hospice Innovation (NPHI) 

National Partnership for Women & Families 

National Patient Advocate Foundation 

National Psoriasis Foundation 

National Taxpayers Union 

Nemours Children’s Health System 

NextGen Healthcare 

Nonin Medical 

North American Primary Care Research Group 

Northfield Hospital + Clinics 

OCHIN 

Ochsner Health 

Omron Healthcare Inc. 

Oncology Nursing Society 

Onduo LLC 

One Medical 

Optimize Health 

Orion Behavioral Health Network 

OrthoVirginia 

Parent Project Muscular Dystrophy 

Parkview Health 

Partnership for AI, Telehealth & Robotics in Healthcare 

PAs in Virtual Medicine and Telemedicine 

Personal Connected Health Alliance 

Physician Assistants in Hospice and Palliative Medicine 

Pillsy Inc. 

Pine Rest Christian Mental Health Services 

Planted Recovery Inc 

Point-of-Care Partners 

Primary Care Collaborative 

Primary Care Development Corporation 

Providence St. Joseph Health 

PursueCare 

Qualtrics 

Quio Technologies 

Rebel Labs Inc. 

Recovr Inc. 

Reflexion Healthcare 

ResMed, Inc. 

ResolutionCare Network, LLC 

Roman Health Ventures Inc. 

Royal Philips 

Rural Hospital Coalition 

San Francisco Tech Council 

Saunders Medical Center 

Scripps Health 

Shriners Hospitals for Children 

Small Business & Entrepreneurship Council 

SOC Telemed 

Society of Hospital Medicine 

Society of Pediatric Nurses 

Society of Teachers of Family Medicine 

Spectrum Health 

Spina Bifida Association 

Stanford Health Care 

Strategic Health Information Exchange Collaborative (SHIEC) 

Strategic Interests, LLC 

Summit Healthcare Regional Medical Center 

Supportive Care Coalition 

Sutter Health 

SYNERGIA Integrated teleBehavioral Health, Inc. 

TapestryHealth 

Taxpayers Protection Alliance 

Teladoc Health 

TeleMed2U 

Texas e-Health Alliance 

Texas Health Information Management Association 

The Center for Telehealth & eHealth Law 

The Commons Project Foundation 

The ERISA Industry Committee 

The Gerontological Advanced Practice Nurses Association 

The Headache and Migraine Policy Forum 

The Jewish Federations of North America 

The Johns Hopkins Health System 

The Joint Commission 

The Learning Corporation 

The Michael J. Fox Foundation for Parkinson’s Research 

The University of Texas at Austin, UT Health Austin 

Third Eye Health, Inc. 

Tourette Association of America 

Treatment Communities of America 

Trinity Health 

TytoCare 

United Spinal Association 

United Urology 

University of California Health 

University of California, Davis Health 

University of Hawaii System 

University of Mississippi Medical Center 

University of Pittsburgh Medical Center (UPMC) 

University of Pittsburgh Medical Center, Pinnacle 

Updox 

URAC 

UsAgainstAlzheimer’s 

Validic, Inc. 

Verato 

VeruStat Inc. 

Virtual Medical Group 

VirtuSense Technologies LLC 

ViTel Net 

Vodafone 

Washington State Society for Post-Acute and Long-Term Care Medicine 

Welcome Home Health, Inc 

Wellbox 

Wisconsin Hospital Association 

Wound Ostomy and Continence Nurses Society (WOCN®) 

Yale New Haven Health System 

Ziegler 

Zipnosis 

Zocdoc 

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