Senator: Bill to Reimburse Home Health for Telehealth Services is Coming
Tuesday, May 26, 2020
Posted by: Kyle Simon
Courtesy of the National Association for Home Care & Hospice (NAHC)
A Senate Special Committee on Aging on Thursday, May 21, heard from multiple witnesses testifying to the need for more telemedicine, particularly in the home health setting, prompting committee chair Senator Susan Collins (R-ME) to say “I plan to introduce a bill soon to create a framework to reimburse for telehealth services provided by home health agencies."
The news, while important, does not come as a complete surprise; NAHC President William A. Dombi announced in a recent Home Health Care News webinar that such legislation could be pending. “I think we’re getting closer to making it happen,” said Dombi.
While home health has long been the more popular and affordable alternative to institutional settings, the coronavirus pandemic has shined a brighter light on the need to expand access to quality care in the home. Roughly one-third of COVID-19 fatalities have come from the nursing home population, even though they account for less than one percent of the American population. In response to those alarming and tragic numbers, University of Chicago professor of health economics and health services research Tamara Konetzka said caring for more patients in the home could save lives.
“We need to enhance the ability of Medicaid beneficiaries to receive home-based services instead of institutional services,” Professor Konetzka, who specializes in post-acute care, testified to the Senate panel.
Other witnesses to the committee included: Steven Landers, MD, MPH, President and CEO, Visiting Nurse Association Health Group (VNAHG); Mark J. Mulligan, MD, Director, Division of Infectious Diseases and Immunology, Langone Vaccine Center, and Director, Thomas S. Murphy Sr. Professor, Department of Medicine, New York University Grossman School of Medicine.
In her opening remarks, Senator Collins described the impact the coronavirus has had on her home state of Maine as well as the United States as a whole. She listed off recent congressional action addressing the pandemic including supports for the national stockpile, aid to health care providers and beleaguered businesses, and assistance to workers, families, and individuals facing COVID-19 related hardships. She paid special attention to the inclusion of her legislation, the Home Health Care Planning Improvement Act in the CARES Act that became law in March. In looking forward, the Senator stated need to protect residents and workers in nursing and assisted living facilities as these settings continue to be hotspots of transmission. These protections included robust testing and worker protections such as adequate access to personal protective equipment. The Senator also emphasized the need to make additional improvements in the application of telehealth, specifically as it pertains to Medicare home health. She announced plans for a forthcoming bill she will be introducing that would provide for reimbursement for home health telehealth services.
In his testimony Dr. Landers gave a description on the pressures VNAHG is facing, including decreased revenues and increased expenses due to COVID-19. He praised past congressional action, such as the provider relief funds included in the CARES Act, which provided much needed stability in times of financial uncertainty, stating that financial support is critical. He went on to discuss the need for reimbursement for telehealth services, describing them as important and critical. He went on to say they “were already finding that telehealth could improve the quality of home care before the crisis, and COVID-19 has reinforced these benefits.” He urged members of the panel to “to explore ways to expand telehealth within home health agencies to prepare for the next phase of the COVID-19 pandemic.”
In a follow-up question for Dr. Landers, Senator Collins asked about isolated seniors and how home health visits can keep seniors more connected. Dr. Landers responded that home health visits show a senior they are known and valued, which is more important in a time of crisis. In some cases nurses are the only people checking in on their patients. He added that telehealth visits bring access and personal attention to patients between in-person visits.
During his time for questions, Ranking Member Bob Casey (D-PA) discussed a proposal he has been championing that would provide additional government funded pay to essential and frontline workers during the COVID-19 pandemic. This concept of added pay was also discussed and encouraged by Senator Kirsten Gillibrand (D-NY).
While much of this hearing focused on COVID-19 related factors such as the need for widespread testing, improvements in nursing and assisted living facilities, and protective personal equipment shortages, it is encouraging to see special attention given to in-home care priorities such as telehealth and essential worker pay.
NAHC will follow developments coming out of this hearing including Senator Collins telehealth legislation and efforts around frontline worker compensation.