Senate panel seeks to expand telehealth for Medicare mental health services

Photo: Kilito Chan/Getty Images

The Senate Finance Committee, led by Chair Ron Wyden (D.Ore.), is seeking to make permanent some of the telehealth flexibilities enacted during the COVID-19 pandemic that pertain to mental health services.

In what the committee calls a mental health "bill of rights," Wyden and ranking committee member Mike Crapo (R-Idaho), along with Senator John Thune (R-S.D.) and Senator Ben Cardin (D-Md.), released a discussion draft for telehealth policies that suggests, among other things, removing Medicare's in-person visit requirement and codifying audio-only mental health coverage.

Wyden said via statement that the policies outlined in the draft "will help strengthen access, awareness and support for telehealth."

Aside from nixing Medicare's in-person visit requirement, the committee's proposed policies include establishing benefit transparency for mental health services delivered via telehealth, to inform Americans with Medicare how and when they can access such services.

The committee also recommended directing Medicare and Medicaid to promote and support provider use of telehealth; and incentivizing states to use their CHIP programs to establish local solutions to serve behavioral health needs in schools, including through telehealth.

The telehealth discussion draft is the first legislative draft released by the committee since it began its larger mental healthcare initiative. Other discussion drafts may be released prior to a committee markup.

The committee said it's committed to fully paying for any mental health package with bipartisan, consensus-driven offsets. Earlier this year, the committee announced five areas of focus for addressing shortfalls in mental healthcare: workforce, care integration, mental health parity, telehealth and youth.

WHAT'S THE IMPACT?

When the pandemic first began, the Centers for Medicare and Medicaid Services waived barriers to telehealth reimbursement, but those flexibilities only last for 151 days after the end of the COVID-19 public health emergency. The current PHE expires in mid-July. If again extended as expected and for another 90 days, the PHE would end in mid-October, just prior to the midterm elections. Most experts have said they expect the PHE to be extended through the end of the year.

To make telehealth flexibilities permanent, CMS needs authority from Congress. Wyden says that the committee's goal is ultimately to craft a behavioral telehealth bill by this summer.

Other proposed policies in the draft include requiring fee-for-service and Medicare Advantage plans to publicly post information on Medicare beneficiaries' rights to receive telehealth services for mental healthcare, plus information on approximate cost-sharing obligations for virtual mental health services.

The committee also recommended:

• mandating that the federal government collect information on trends and care quality and give regular reports to lawmakers.
• requiring that Medicare give providers guidance on improving access to virtual mental healthcare for those with language barriers and hearing or vision impairments.

"Telehealth, particularly for behavioral health services, has become an essential component of care, and I am pleased that we have this opportunity to improve access to telemental health care, particularly for underserved communities," said Cardin.

THE LARGER TREND

The draft comes at a time when mental health concerns are rising for many Americans. Earlier this month a CVS Health/Morning Consult poll showed Americans of all backgrounds, but especially those who are Black, young adults, older than 65 or who identify as LGBTQIA+, are increasingly concerned about mental health and how to access care.

Results show that a majority of respondents, 59%, have experienced concerns about either their own mental health or that of family and friends. That's a 9% increase since April 2020. Another majority, 53%, agree that hearing about other people's challenges makes them more comfortable seeking out resources and care for themselves.

A 2021 study showed that mental health services accounted for the most common use of telehealth during the early days of the pandemic. In the midst of skyrocketing depression rates, the findings show that more patients used telehealth for behavioral, rather than physical conditions.

A report from health insurer Cigna, also released last year, made it clear that businesses have taken notice of this shift to behavioral telehealth: Some 44% of human resources decision-makers and 27% of health plan leaders said that increased access to mental health services will become a long-term solution for their organization. Some 57% of health plan leaders said they had seen the value of mental health services increase more than for most other services and benefits as a result of the coronavirus.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com