100+ orgs urge CMS to keep work-from-home telehealth flexibilities

 The meteoric rise of telehealth during the pandemic has helped to reimagine the way care can be delivered, offering virus protection for patients and providers while expanding and improving the delivery of crucial care services. 

Early in the pandemic, a number of governmental agencies, including CMS, encouraged rapid uptake of virtual care modalities by introducing a series of flexibilities, some of which have been extended or made permanent past the official end of the COVID-19 Public Health Emergency (PHE) declaration, which expired in May of 2023. 

Now, more than 110 healthcare organizations are urging CMS to add a key work-from-home provision to that list.   

The American Telemedicine Association (ATA) has published a letter asking the agency to preserve rules that allow telehealth providers to practice from their homes without being forced to reveal their home address in Medicare documentation. 

Under the pandemic-era “distant site” flexibilities, practitioners are allowed to bill for services rendered from their home offices without being physically present in an approved location, such as a clinic or hospital, whose real-world address is linked to a Medicare billing account. 

Due to a lack of clarity in statue, however, ending this flexibility may require home-based practitioners to list their home addresses as the site of practice in public Medicare documents, which could expose providers to the threat of harm from disgruntled patients or other individuals. 

Codifying the new rules, or developing an alternate method of determining site of practice, would eliminate this uncertainty and protect workers from having to expose potentially sensitive information. 

“The provision of remote health care services offers great benefit not only to the patient receiving the services, but to the provider as well,” the letter states. “Allowing appropriately licensed and credentialed providers to practice telehealth from their home improves patient access to healthcare services, reduces healthcare costs, while maintaining and meeting patient demand for care.” 

The ability to work from a distant site allowed providers to remain safely quarantined at home and offered the same work-from-home benefits that other workers in other industries have capitalized upon, including eliminating the time and expense of commuting and making it easier to balance family and work obligations. 

“This was necessary during the height of the COVID-19 pandemic and remains just as important today amidst provider workforce shortages and burnout, given that 78 percent of health care practitioners agree that retaining the option to provide virtual care from a location convenient to the practitioner would ‘significantly reduce the challenges of stress, burnout, or fatigue’ facing their profession and 8 in 10 indicate that this flexibility would make them more likely to continue providing medical care,” the ATA adds, citing a 2022 survey from the Alliance for Connected Care. 

But requiring providers to list their home addresses could squeeze even more providers out of an industry still reeling from the effects of the “Great Resignation,” which hit healthcare particularly hard. With the pandemic compounding the effects of massive pre-existing provider shortages, healthcare organizations simply cannot afford to lose more staff to a preventable technicality, the ATA asserts. 

The advocacy group is requesting two actions from CMS before the relevant provisions expire in December of 2023. First, CMS should permanently allow practitioners to use an approved in-person care location as the physical address to bill for services, even when those services are being provided from the practitioner’s home or other location via telehealth. 

Second, for practitioners that don’t have a physical practice location, CMS should work with industry leaders to develop an alternate method of determining the location of care without requiring practitioners to use their home address. The ATA suggests that providers might be allowed to use a business address for enrollment purposes and a ZIP code for geographic cost and wage adjustments. 

“This is an extremely important issue for the healthcare providers in general and the telehealth community in particular,” the letter concludes. “As providers are beginning to update their practice and systems in a post pandemic era, we should arm them with the tools to continue to offer telehealth services as they see clinically appropriate.”

“Strong, relationship-based patient care requires that we move beyond location-based care to allow a practitioner to offer the same telehealth services from home, from a clinic, from an academic office, or from any other clinically appropriate location – allowing them to meet patient needs when they happen – without incurring burdensome additional documentation requirements.” 

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.  She can be reached at jennifer@inklesscreative.com.