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Bill Extends Medicare Telehealth Coverage for Therapy Providers

As part of the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 and Coronavirus Aid, Relief, and Economic Security (CARES) Act, the federal government expanded Medicare reimbursement for telehealth services. In subsequent guidance and rulemaking, CMS provided expanded telehealth billing codes to allow for reimbursement of telehealth therapy services (e.g., physical therapy and occupational therapy) during the public health emergency. However, while reimbursement was expanded for telehealth therapy services, usage of the codes has not been possible because certain therapy providers are not identified as eligible distant site providers under Section 1834(m) of the Social Security Act. This absence has caused confusion amongst the patient and provider community regarding who can provide and bill for Medicare-covered therapy services during the public health emergency.

In an April 14, 2020, letter to Health and Human Services Secretary Alex Azar, a group of bipartisan members of Congress sought further clarification on this issue and requested that physical therapists, occupational therapists, speech language pathologists and audiologists be reimbursed through Medicare for telehealth services.

On April 28, 2020, Rep. Cynthia Axne (IA-03), Rep. Troy Balderson (OH-12) and Rep. French Hill (AR-02) introduced bipartisan legislation, the Emergency COVID Telehealth Response Act, aimed at addressing this disconnect by including therapy providers in the definition of eligible distant site providers. Specifically, the proposed legislation provides that a practitioner described in section 1834(m) of the Social Security Act includes the following providers:

  • Physical therapists

  • Physical therapist assistants working under the supervision of a physical therapist

  • Occupational therapists

  • Occupational therapy assistants working under the supervision of an occupational therapist

  • Speech-language pathologists

  • Clinical social workers (as defined in section 1861(hh)(1) of the Social Security Act)

  • Audiologists.

If passed, the Emergency COVID Telehealth Response Act will permit therapy providers to take advantage of Medicare’s more flexible telehealth reimbursement policies in response to Coronavirus (COVID-19) and allow Medicare beneficiaries to receive telehealth therapy services from the comfort of their home without risk of exposure. By introducing this bill, lawmakers continue to signal to CMS that it should prioritize expanding the types of providers eligible to furnish telehealth services for the duration of the COVID-19 public health emergency to include therapy providers.

This On the Subject was co-authored with Rachel Stauffer, Director at McDermott+Consulting.

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© 2020 McDermott Will & EmeryNational Law Review, Volume X, Number 120
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About this Author

Marshall E. Jackson, Jr. Partner  Washington, DC Regulatory, Government & Lobbying Strategies  Healthcare  Digital Health
Partner

Marshall E. Jackson, Jr. focuses his practice on transactional and regulatory counseling for clients in the healthcare industry, as well as advises clients on the legal, regulatory and compliance aspects of digital health.

 

Health Transactions and Regulatory Compliance

Marshall provides counseling and advice to hospitals and health systems, private equity firms and their portfolio companies, post/sub-acute providers, physician practices, and other public and private healthcare companies in a variety of complex transactions and health regulatory...

202-756-8019
Emma J. Chapman Healthcare Lawyer McDermott
Associate

Emma J. Chapman provides regulatory and compliance advice to health care providers. She is particularly focused on emerging health care technology solutions and the regulatory issues that impact them, including telehealth and digital health matters. During law school, Emma served as a senior staff editor for the Food and Drug Law Journal and as a Law Fellow for the first-year legal research and writing program.

Prior to law school, Emma worked for a company specializing in complex class action settlements in the health care space, where she coordinated a multimillion dollar...

202 756 8423
Lisa Schmitz Mazur, Health Law Attorney, McDermott Will Law Firm
Partner

Lisa Schmitz Mazur is a partner in the law firm of McDermott Will & Emery LLP and is based in the Firm’s Chicago office.  Lisa maintains a general health industry practice, focusing on the representation of hospitals and health systems and other health industry providers.

Lisa’s representation of hospitals and health systems includes providing guidance on not-for-profit corporate governance matters, tax-exemption issues, conflict of interest compliance and overall corporate compliance effectiveness.  In addition, Lisa regularly assists hospital and health system clients to...

312-984-3275
Dawn R. Helak Healthcare Attorney McDermott Will & Emery Washington, DC
Partner

Dawn R. Helak provides counseling and advice to hospitals and health systems, academic medical centers (AMCs), private equity firms and their portfolio companies, post/sub-acute providers, trade associations and coalitions, physician practices, and other public and private health care companies in a variety of complex transactions and health regulatory compliance matters. Dawn has experience in all aspects of health care transactions, including mergers, acquisitions, joint ventures and strategic affiliations. Dawn focuses her regulatory practice on advising clients with respect to federal...

202-756-8664
Rachel Stauffer, McDermott Law Firm, Washington DC, Health Policy Consultant

Rachel is a highly experienced government relations and legislative affairs strategist and advocate who is informed by a solid foundation of health policy knowledge.

Prior to joining McDermottPlus, Rachel served as the director of policy and government relations for a health IT contractor, where she developed the company’s first strategic plan for government relations. She grew the company’s profile on Capitol Hill by establishing new relationships with key leaders in the federal, state and military health program space. As a result, the company...

202-204-1460
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