Increase awareness of telehealth rights in Medicare
Recommendation
Congress should require original Medicare Fee-for-Service and Medicare Advantage plans to implement an awareness and education campaign regarding Medicare beneficiaries’ rights to receive telehealth services for mental health/substance use disorder (MH/SUD) treatment, as well as information on approximate cost-sharing obligations for telemental health services.[1]
Background/summary
While telehealth utilization has decreased slightly from COVID-19 pandemic peaks, demand has remained high for mental health and substance use disorder (MH/SUD) treatment.[2] Telehealth services for MH/SUD treatment can improve patient access, as providers can serve more geographically dispersed populations and help alleviate provider shortages in underserved areas. However, telehealth adoption for Medicare beneficiaries has consistently lagged behind adoption among those with private insurance.[3]
Although the Centers for Medicare and Medicaid Services (CMS) has made policy changes to facilitate access to telehealth services for Medicare beneficiaries during the Covid-19 Pandemic, beneficiaries may not have a clear understanding of what services are covered currently.[4][5] It is imperative this population have clear guidance on their rights to receive telehealth services for MH/SUD and related cost-sharing obligations so they are empowered to make informed decisions about their care.[1] The Department for Health and Human Services (HHS) has provided some guidance on how to inform patients about their options, but this is not sufficient as it relies heavily on individual providers and plans to act.[6] Congress should require CMS and any health plan serving Medicare beneficiaries to implement an awareness and education campaign about the telehealth services available to them, including MH/SUD treatment.
citations
1. Senate Finance Committee. 2022. “SFC Bipartisan Mental Health Care Provisions”. Last Accessed July 31, 2023.
2. U.S. Department of Health & Human Services, Office of Health Policy. “Updated National Survey Trends in Telehealth Utilization and Modality.” Last Updated April 19, 2023.
3. LaPointe, Jacqueline. 2018. “Medicare Reimbursement Rules Limit Telehealth Adoption.” TechTarget: Revcycle Intelligence. Last Updated November 26, 2018.
4. Robeznieks, Andis. CMS OKs pay parity for telephone visits during COVID-19 crisis. American Medical Association. Last Accessed July 31, 2023.
5. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. Telehealth. Last Accessed July 31, 2023.
6. Department of Health and Human Services, Health Resources and Services Administration. Announcing the Availability of Telehealth. Last Updated February 25, 2021.