Expanding telehealth services

What is telehealth? 

Telehealth services, also known as telemedicine or remote medicine, allow patients to ‘see’ and interact with their healthcare providers without being physically in the same place. These services can include phone calls, video chat appointments, remote monitoring of patient vital signs, and communicating via secure email. 

While technology allows many types of health services to now be delivered remotely, laws have not kept pace. For example, Medicare coverage and reimbursement rules, conflicts with patient privacy laws (specifically the Health Insurance Portability and Accountability Act of 1996 (HIPAA)), and state-based healthcare professional licensing remain barriers to telehealth access. 

Why is telehealth flexibility important for those with PI? 

Individuals with primary immunodeficiencies (PI) are immunocompromised and susceptible to infections. The ability to receive healthcare services at home allows those with PI to avoid being in environments where they are likely to encounter germs, such as doctor’s offices and outpatient clinics.

While private insurers have varying telehealth coverage policies, Medicare rules strongly influence the development of private insurance coverage policies and practices. During the COVID-19 public health emergency, patients had expanded access to and coverage of telehealth because of policy flexibilities, but those policies either expired with the emergency declaration or will expire on December 31, 2024. Expiring policy changes include:

• Allowing Medicare beneficiaries to receive telehealth services in their homes, in audio-only formats for most services, and without a prior in-person appointment for behavioral health services.
• Allowing employers offering high deductible health plans to offer pre-deductible coverage for telehealth services.
• Allowing healthcare providers to use widely available, non-public-facing applications like Zoom and WhatsApp without having to verify that they are HIPAA-compliant.
• Waiving state licensure requirements so that healthcare providers using telehealth can practice across state lines.

As such, IDF supports legislation, such as the Telehealth Modernization Act (H.R. 7623), that will make expanded telehealth access and coverage within Medicare permanent, as well as state and federal legislation that removes other telehealth services barriers.