WASHINGTON — A bipartisan group of U.S. senators, including both of West Virginia's representatives, is urging federal agencies to give equal reimbursement for telephone-based, audio-only services as other telehealth services.
According to a joint press release from Sens. Joe Manchin, D, and Shelley Moore Capito, R, Medicare and Medicaid reimbursements to health care providers for audio-only services are lower than those for audio-visual services and for in-person services.
The 37-senator group sent a letter to U.S. Department of Health and Human Services Secretary Alex Azar and Centers for Medicare & Medicaid Services Administrator Seema Verma expressing their concerns and urging action.
"Access to audio-only telephone-based services during this time is not only important for Medicare beneficiaries with limited means, but is also vital for Medicare patients who live in communities that lack sufficient broadband and internet connectivity," the letter reads. "For these communities, telehealth services provided through internet based visual platforms are simply not an option."
According to the release, leaders of some health care groups in West Virginia have expressed the same concerns regarding the reimbursement.
“The West Virginia Board of Medicine recognizes that the citizens of West Virginia are among the most vulnerable in relation to the COVID-19 virus,” said Kishore K. Challa, MD, FACC, president of the West Virginia Board of Medicine. "Therefore, any temporary modifications that will allow for increased patient access, via telemedicine, to qualified providers during these unprecedented times is crucially important. We appreciate Senators Manchin and Capito and their commitment and leadership during this pandemic."
Danny Scalise, executive director of the West Virginia State Medical Association, commended Manchin and Capito's efforts on the issue.
“We are proud to care for our fellow West Virginians and we understand that many do not have access to broadband, making it difficult to use visual telehealth options and because of the COVID-19 pandemic, the majority of our patients are unable to visit us in-person. That is why it is essential our providers are reimbursed equally for their audio-only consultations so they can continue to run their offices and provide care to West Virginians throughout this pandemic,” Scalise said.
In the letter, senators asked the secretary and administrator to:
• Increase Medicare payment rates for telephone-based evaluation and management codes to bring payments for these codes equal to Medicare’s established in person visit codes that will ensure that patients without advanced video-sharing capabilities are able to get care virtually, while helping to sustain physician practices.
• Immediately provide guidance to Medicare Administrative Contractors to ensure that recent CMS guidance and rules are followed appropriately to enable the payment of telephone evaluation and management claims.
• Provide Congress with a briefing on those efforts to address this issue by May 8.