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Legislation concerns telehealth, chronic care, payment reform, climate change and prescription drugs

Oct. 11, 2024 (ACP) -- The �������ý is lobbying the nation's leaders to pass several crucial pieces of legislation as the congressional term nears its end. At stake are efforts to extend telehealth flexibilities, strengthen the health care system and support physicians.

Here is a closer look at important bills that ACP hopes Congress will address quickly.

Telehealth Legislation

ACP supports the Preserving Telehealth, Hospital and Ambulance Access Act, which would extend telehealth flexibilities implemented during the COVID-19 pandemic for two years until the end of 2026.

Among other things, the legislation delays the in-person requirements under Medicare for behavioral health services furnished through telehealth and telecommunications technology and allows the furnishing of audio-only telehealth services.

ACP is also urging Congress to pass three related bills: the CONNECT for Health Act, the Protecting Rural Telehealth Access Act and the Telehealth Modernization Act.

The CONNECT for Health Act would permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites, permanently allow health centers and rural health clinics to provide telehealth services, and allow more eligible health care professionals to utilize telehealth services.

It would also remove unnecessary in-person visit requirements for telehealth behavioral health services and allow for the waiver of telehealth restrictions during public health emergencies.

The Protecting Rural Telehealth Access Act makes permanent the Medicare coverage of telehealth services that was allowed during the COVID-19 pandemic. And the Telehealth Modernization Act would help ensure that seniors and rural patients who may not have internet connectivity receive the care they need through audio-only telehealth services.

“Because of its bipartisan support, I expect a two-year extension of telehealth flexibilities to pass, maybe during the lame duck session of Congress,” said George Lyons, Esq., ACP director of legislative affairs. However, “because of the cost, I do not expect any of the bills making the telehealth flexibilities permanent to pass.”

Chronic Care

ACP urges Congress to pass the Chronic Care Management Improvement Act, which would remove the cost-sharing requirement for patients to access chronic care management services. “We believe that access to chronic care services remains low due to patient cost sharing associated with this code,” Lyons said.

ACP also urges Congress to ensure that progress on the chronic-care front does not stall by passing the Resident Physician Shortage Reduction Act, which would gradually raise the number of Medicare-supported graduate medical education positions by 2,000 per year for seven years.

Payment Reform

ACP is urging Congress to take bipartisan action to ensure that the Medicare Physician Fee Schedule provides the resources necessary for physicians to deliver high-quality care to patients.

“ACP urges Congress to pass the Strengthening Medicare for Patients and Providers Act to provide an annual Medicare physician payment update tied to inflation, as measured by the Medicare Economic Index (MEI),” Lyons explained. “This would allow physicians to make needed investments in their practices to help ensure that they are able to deliver high-quality care to their patients.”

ACP also supports the Provider Reimbursement Stability Act, which would give the Centers for Medicare and Medicaid Services more flexibility in setting payment rates. An alternative bill, the Physician Fee Schedule Update and Improvements Act, would also raise the threshold for implementing budget-neutral payment cuts from $20 million to $53 million and would provide an increased update to the threshold every five years afterward based on the MEI.

In addition, ACP supports extending incentive payments for participation in eligible alternative payment models (APMs) through 2026. The College is lobbying Congress to pass the Value in Health Care Act to extend the 5 percent bonus for physician participation in advanced APMs.

Climate Change and Prescription Drugs

“ACP opposes efforts by the House to roll back or delay implementation of the climate change provisions of the Inflation Reduction Act,” Lyons said. “We support legislation that expands upon the number of prescription drugs for which Medicare can negotiate the prices. We support the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs that Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029.”

In September, Congress passed legislation to fund the government through Dec. 20.

“Congress will have to address appropriations during the lame duck end-of-year session to pass annual funding bills for the rest of the 2025 fiscal year or punt spending decisions once again into the next presidential administration,” Lyons said. “The fate of averting in whole or part of Medicare physician payment cuts slated for Jan. 1, 2025, is most likely to be addressed with these lame duck funding discussions. There is bipartisan support to address the pay cuts, but what amount of the cuts that will be addressed will depend upon how Congress chooses to pay for the fix.”

He added that “the outcome of the election could affect what gets done during the lame duck session. If the election results are mixed, there may be a tendency for Congress to address the appropriations and spending bills during the lame duck. If the Republicans secure a clean sweep of the White House and Congress, there may be a push for a continuing resolution extending these discussions into next year in order to secure larger cuts in federal spending.”

Back to the October 11, 2024 issue of ACP Advocate