Flexibilities for telehealth treatments of Medicare patients through the Centers for Medicare & Medicaid Services (CMS) will remain in place for the duration of the public health emergency (PHE), which is currently set to expire on Oct. 25. Legislation that would make permanent many of the telehealth expansion parameters, including evaluation and management (E/M) visits for established patients, would allow providers to shift appropriate care to this platform and expand patient access, Ms. Shewmaker explains, echoing similar discussion from an issue brief the ACR created to guide conversation with legislators during the event. “Our member advocates stressed appreciation for the agency’s recognition of the value of telehealth for our patients and the recognition that action is necessary to preserve telehealth as a valuable platform after the public health emergency ends.”
Advocates also stressed that further support for rheumatology telehealth during and after the PHE will require two important solutions proposed through current legislation:
- Parity for telehealth under ERISA plans, which asks Congress to follow CMS’s lead and reimburse for audio-only E/M visits at the same rate as audio-video and in-person evaluations through the PHE to deliver efficient healthcare and support broader access for those in rural and underserved areas. This reimbursement is outlined in the Health Care at Home Act (H.R. 6644/S. 3741).
- Update telehealth delivery restrictions to improve health outcomes by applying lessons learned through telehealth delivery during the PHE permanently to telehealth services through Medicare. This would make it easier for patients to connect with their providers while creating cost savings for patients and providers. These updates are covered in the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act (H.R. 4932/S. 2741).
Workforce Demands
“During the COVID-19 pandemic, ongoing concerns with workforce shortages among rheumatologists and rheumatology health professionals have become a more pressing issue, and congressional action is critical to address the workforce needs,” says Dr. Solow.
Several pieces of active legislation to address workforce shortages were discussed during the event and shared through an issue brief left with legislators. For example, the ACR supports actions to raise the cap on funding for graduate medical education slots as outlined in the Resident Physician Shortage Reduction Act (H.R. 1763/S. 348).
Advocates also spoke out in support of funding the Pediatric Subspecialty Loan Repayment Program, based on estimates from the ACR’s 2015 Rheumatology Workforce Study suggesting nearly 300,000 American children have juvenile arthritis, but fewer than 400 board-certified pediatric rheumatologists are practicing in the U.S.1
