Telemedicine Reimbursement and Regulation: A Permanent Solution Elusive
For Medicare, telemedicine reimbursement and regulation has been about kicking the can down the road – more temporary extensions of COVID-era flexibilities. The current ones run out on September 30.
A Permanent Solution Remains Elusive
It’s April 2025 and healthcare still waits for a permanent solution from the government for telemedicine and Medicare – which tends to drive what Medicaid and private insurers do. Will October 1 find the industry with a permanent solution or another kick of the can down the road?
Experts Weigh In
Dr. Ateev Mehrotra is chair of the department of health services, policy and practice at Brown University School of Public Health. He is an expert in telemedicine policy. Healthcare IT News sat down with him for a wide-ranging discussion on the future of telemedicine reimbursement and regulation.
Q. September 30 is the new deadline for more telemedicine flexibilities. Where do things stand, and what is your opinion of how this is going to shake out?
A. I often struggle to answer this question. On the one hand, it’s a very, very easy answer. There is broad bipartisan support for telehealth, and it’s very hard for me to find anyone who objects to a permanent expansion. In essence, it’s not the merits of telehealth, though there’s some nuances, but generally people are enthusiastic. It’s really coming down to the money.
Implications of a Permanent Solution
Q. What will be the implications if the flexibilities are stopped? September 30 comes along, and Congress does not pass anything. Or, what will be the implications if the flexibilities are kicked down the road again?
A. If they’re stopped, this is going to be quite devastating for some patients who’ve come to depend on telehealth, either because of their life circumstances, difficulty with travel, distance to see their clinicians – and it’s going to decrease continuity of care in that context. And for clinicians who have become accustomed to providing this care.
Stifling Innovation
Q. You say, “Temporary interventions are stifling innovation.” Can you talk about that a bit?
A. If we want telehealth to be incorporated into routine care, then there needs to be changes in where health systems invest, how clinicians structure their weekly schedules, how the scheduling system works, the software we use, the contracts with the electronic health record vendors to implement and support telehealth.
Solution
Q. What, in your mind, is the solution to this challenge? And do you think the solution has a reasonable chance of being successfully implemented?
A. At the end of the day, I think it’s easy: Just take the word “temporary” and make it “permanent” and let’s move on with life. There are some nuances to that. I have advocated that the actual payment for telehealth visits be a little bit less than in-person visits. That way, the pay-for is a little bit less, so it’s more sustainable.
Conclusion
A permanent solution to telemedicine reimbursement and regulation remains elusive, with the current temporary extensions set to expire on September 30. Experts like Dr. Ateev Mehrotra believe that the solution lies in making the temporary extensions permanent, citing broad bipartisan support for telehealth. However, the lack of a clear pay-for has been a major obstacle to implementing a permanent solution.
FAQs
Q: What is the current deadline for telemedicine flexibilities?
A: September 30.
Q: What are the implications if the flexibilities are stopped?
A: It will be devastating for patients and clinicians who have come to depend on telehealth, leading to decreased continuity of care.
Q: Why are temporary extensions stifling innovation?
A: They are undermining investment and organization in telehealth, making it difficult for companies to plan for the future.
Q: What is the solution to this challenge?
A: Making the temporary extensions permanent, with some nuances, such as reducing the payment for telehealth visits to make it more sustainable.
