Prior to COVID-19, some of the patients seeing dermatologist Jack Resneck Jr., MD, had to drive several hours to his practice to get care for serious chronic conditions. In some cases, those in-person visits were absolutely necessary, but Dr. Resneck wanted more options for telehealth and few payers were offering coverage for virtual visits.
The pandemic changed everything, said Dr. Resneck, the AMA’s president-elect and professor and vice chair of dermatology at the University of California, San Francisco School of Medicine. Telehealth skyrocketed early in the pandemic because the payment and regulatory barriers were removed temporarily to enable patients to stay safer at home.
Although 30 states now have telemedicine parity laws in place, outdated Medicare rules could roll back provisions, jeopardizing telehealth access for seniors.
During a recent episode of “AMA Moving Medicine,” Dr. Resneck talks about AMA’s advocacy efforts to retain telehealth coverage, both in the Medicare and commercial space, and why this option is so crucial to patient care.
Game-changer for medicine
As COVID-19 upended access for patients across the country, the AMA took proactive efforts to get Medicare to start broadly covering telehealth visits, said Dr. Resneck. “A lot of private insurers quickly followed suit, and the use of telemedicine really, really took off.”
Many patients embraced the technology. They could see physicians safely at home, avoiding struggles with transportation, work and childcare issues. The technology also benefited groups of patients who have been economically or socially marginalized, as well as rural and inner-city areas that had long-standing problems with healthcare access.
Access to audio-only visits is also important for patients who don’t have high speed connections or struggle with telehealth technology, he stressed.
Through new coverage options, “we were able, as physicians across the country were, to actually do follow up and continue to take care of patients who we knew and knew us,” said Dr. Resneck.
The benefits of expanded telemedicine are clear. Join physicians who are advocating to permanently expand virtual care coverage.
Fair, equitable payment
Coverage for telehealth should be fair and equitable and not limited to select online providers, he continued.
“Patients really need to have access to their existing health care teams for telemedicine or to get new consults from a new physician in a health system that already knows them and in practices that work together,” said Dr. Resneck, who has been pushing for telemedicine payment at the same rate for similar services conducted in a physician’s office.
Old rules threaten access
Once the federal government lifts the public health emergency related to COVID-19, Medicare rules dating back to 1997 will automatically snap back into place. “Essentially what that means for Medicare patients is that unless they live in a rural area, their telehealth coverage will just end,” cautioned Dr. Resneck.
Even those living in rural areas face certain restrictions—they won't be able to use phones or computers in their homes anymore. Instead, they’ll have to go to an authorized health center to access telehealth.
Call for legislative fixes
Congress must act to prevent this from happening, Dr. Resneck emphasized.
The AMA has supported permanent fixes to originating site and geographic restrictions on telehealth coverage for Medicare patients. The Telehealth Modernization Act of 2021 (HR 1332) and the CONNECT for Health Act of 2021 (S 1512) would change that.
This is not just about Medicare, said Dr. Resneck. “The same threat exists in the private insurance marketplace. We're working to ensure that commercial insurers also don't retreat to no longer covering telehealth.”
He urged physicians to call or email their congressmen or senators to stress the importance of this coverage or join AMA to support these efforts. The Physicians Grassroots Network makes it easy to have your voice heard on telemedicine.
“AMA Moving Medicine” highlights innovation and the emerging issues that impact physicians and public health today. You can catch every episode by subscribing to the AMA’s YouTube channel or the audio-only podcast version, which also features educational presentations and in-depth discussions.