Proposed New Bill Provides for Telehealth Reimbursement in Home Health Care

The emergence of the COVID-19 pandemic brought telehealth, aka telemedicine, to the forefront with investor funding increasing and restrictions loosening. According to Benefits Pro, this year alone investor dollars have raised $9.4 billion for digital health. Medicare waived many of its restrictions, which prior to the pandemic included physicians receiving either lower reimbursements than in-person visits or no compensation whatsoever. Also, as a result of the pandemic, up to $250 billion of U.S. health care spending could come from virtual medicine.

With telehealth a vital component of today’s healthcare, in October Senators Susan Collins (R-ME) and  Ben Cardin (D-MD) introduced the Home Health Emergency Access to Telehealth (HEAT) Act. The bipartisan bill would provide Medicare reimbursement for audio and video telehealth services furnished by home health agencies during the COVID-19 emergency – something the home health care industry has been requesting since the onset of the pandemic. Similar legislation has also been introduced in the House. 

“Home health serves a vital role in helping our nation’s seniors avoid more costly hospital visits and nursing home stays,” Senator Collins, chairman of the Senate Aging Committee, said in a statement on her website. “This bipartisan bill would ensure that seniors in Maine and across the country retain access to remote home health services during the COVID-19 emergency and future public health emergencies.”

“I know firsthand the benefits of home health care,” Congresswoman Terri Sewell (D-AL) said in a statement. “When my dad was left wheelchair-bound after a series of strokes, we were fortunate enough to find home health care from highly skilled and caring health care professionals right where he wanted to be — at home in Selma. As a passionate supporter of protecting home health services, I’m proud to introduce the bicameral and bipartisan [HEAT Act], which will ensure that home health providers have the resources necessary to protect patients in their homes and health care professionals during the duration of the COVID-19 pandemic.”

Inside the HEAT Act

The HEAT Act, if passed, would authorize Medicare reimbursement for home health services provided through telehealth during a public health emergency where telehealth can be used appropriately.  There are a number of stipulations in the proposed legislation in place to protect Medicare beneficiaries and the Medicare program: 

  • The services would not be reimbursed unless the beneficiary consents to receive the services via telehealth. 
  • To ensure that the Medicare home health benefit does not become a telehealth-only benefit, Medicare reimbursement would only be provided if the telehealth services constitute no more than half of the billable visits made during the 30-day payment period. 
  • A pre-existing relationship with the physician or other practitioner ordering home health must be in place prior to the start of telehealth for home care services.

NAHC Among Supporters of Bipartisan Bill

The bipartisan bill has been endorsed by several home health care organizations and agencies, including LeadingAge, the Visiting Nurse Associations of America, the National Association for Home Care & Hospice (NAHC), and the Partnership for Quality Home Healthcare.

“From the early onset of the COVID-19 pandemic it has been well known that limiting person-to-person contact is key in reducing transmission and infection rates,” said Bill Dombi, President of NAHC.  “Enabling home health agencies to incorporate telehealth visits into the plan of care, with reimbursement, will unlock new means of safe care delivery bringing peace of mind to Medicare beneficiaries. This bill will ensure that home health providers are able to utilize the full array of tools at their fingertips to reduce the risk of virus transmission, protecting patients in their homes, and health care professionals on the frontlines.”

Manchester Specialty Programs will continue to keep abreast of the proposed legislation. We provide agents and brokers with the ability to offer a totally integrated business insurance solution around the specific needs of Home Care, Allied Health and Human/Social Services organizations fundamental to communities. For more information about our products, please contact us at 855.972.9399.

Sources: Susan Collins official website, Home Health Care News, LeadingAge