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US Reps Push for Extension of Telehealth Flexibilities for HDHP Members

Mark Melchionna

December 15, 2022

Three US Representatives led a bipartisan group of lawmakers in submitting a request to Congress to extend telehealth flexibilities for some high-deductible health plan members.

In anticipation of critical telehealth flexibilities expiring on Dec. 31, US Representatives Michelle Steel (CA-48), Brad Schneider (IL-10), and Susie Lee (NV-3), along with a bipartisan group of 30 Congress members, sent a letter requesting that House leadership include two pieces of legislation that extend some flexibilities in a year-end package.

When the COVID-19 pandemic began, patients and providers turned to telehealth in droves to maintain care. According to the Centers for Disease Control and Prevention (CDC), there was a 154 percent increase in telehealth visits when comparing data from the last week of March 2020 with that of March 2019.

This uptake of telehealth was likely associated with the withdrawal of regulatory restrictions in response to the limitations placed on in-person care during the public health emergency.

As part of the CARES Act of 2020, Congress passed reforms that expanded access to telehealth services. For instance, prior to the CARES Act, Americans with high-deductible health plans (HDHPs) coupled with health savings accounts (HSAs) had to reach the minimum deductible before they qualified for telehealth coverage.

However, Section 3701 of the CARES Act eliminated this requirement initially through Dec. 31, 2021. The provision was later extended through the Consolidated Appropriations Act, 2022.

This led to wider coverage of telehealth services as health plans and employers were able to expand access to virtual care services for individuals with HDHP-HSAs pre-deductible. According to the representatives, increased access has led to many benefits for patients, particularly those without access to transportation services and those who reside far away from clinical locations.

“Access to telehealth has also provided a significant portion of the U.S. workforce relief at a time when household costs are rising. Telehealth has allowed families to avoid taking time off from work to travel to and from appointments, and timely care has helped prevent costly visits to urgent care or the emergency room. Unfortunately, those with a high deductible may decide to skip critical preventative services – including primary care and behavioral health services – if the deductible is not waived, often leading to poor health outcomes and more costly care down the line,” the letter states.

Due to the increasingly apparent benefits of telehealth, the US representatives are requesting that House leadership include the Primary and Virtual Care Affordability Act and the Telehealth Expansion Act in the end-of-the-year package. The Telehealth Expansion Act would make the telehealth flexibility permanent for people with HDHP-HSAs. The Primary and Virtual Care Affordability Act would both extend the flexibility and allow insurance providers to cover primary care services pre-deductible.

This letter is part of a larger effort among healthcare stakeholders to ensure that expanded access to telehealth is solidified.

Another letter written by the Connected Health Initiative (CHI) requested that Congress extend the safe harbor for telehealth coverage by HDHPs.

In the letter, CHI noted its support for removing restrictions impeding telehealth access among Medicare beneficiaries. It also emphasized the upcoming telehealth deadline Americans with HDHPs will face at the end of 2022.

Due to this, CHI requested that Congress extend the safe harbor for HDHPs to cover telehealth with first-dollar coverage. This would also allow them to maintain HDHP status.

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