Aetna to cut coverage for audio-only and asynchronous text-based telehealth visits

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Aetna is modifying its commercial policy to no longer cover certain telemedicine services starting on Dec. 1, the company said by statement.

This is for audio-only and asynchronous text-based visits that were expanded under the public health emergency, the CVS subsidiary said. 

"The modifications are in line with the industry as a result of the expected PHE ending in May 2023," Aetna said. "Telemedicine services that remain covered for Aetna Commercial plan sponsors are actually more extensive than what was provided pre-pandemic because of the access and value these services clearly bring to our members and providers." 

According to Aetna, currently covered telehealth services include routine care, sick visits, urgent care through walk-in clinics, prescription refills and behavioral health services.

WHY THIS MATTERS

Payers, providers and the federal government are figuring out the telehealth landscape after the end of the public health emergency on May 11.

ATA has said 2024 will be a decision-making year as it "is shaping up to be the Super Bowl for telehealth, with many of the telehealth flexibilities enacted during the public health emergency set to expire at the end of 2024."

This includes geographic and originating site flexibilities, Medicare's telemental health in-person requirements, Medicare face-to-face telehealth requirements for hospice care and the Acute Hospital Care at Home Program.

The Drug Enforcement Administration on Friday extended flexibilities for remote prescribing of controlled substances through the end of 2024 as it mulls new regulations.

THE LARGER TREND

Telehealth use soared under flexibilities allowed during the COVID-19 pandemic.

Payment parity for virtual services remains an issue, with the Centers for Medicare and Medicaid Services saying Congress needs to act on telehealth decision-making.

Twitter: @SusanJMorse
Email the writer: SMorse@himss.org