Washington, DC – The ERISA Industry Committee (ERIC) provided testimony to the U.S. Senate Committee on Health, Education, Labor and Pensions for its hearing titled “Telehealth: Lessons from the COVID-19 Pandemic.”
ERIC’s testimony focused on how government rules and special interest proposals are stifling the ability of patients in the private sector to access health care providers through telehealth, and what Congress can do right now to open up that access. It also called for Congress to make COVID-related telehealth relief permanent.
“At a time when Americans were forced to stay home due to COVID-19, millions of people were forced to go without care because they did not have access to telehealth, or to a sufficient number of telehealth providers,” said James Gelfand, Senior Vice President of Health Policy, ERIC. “There is no reason why, in 2020, every American should not be able to access a willing provider through technology. It’s time to eliminate the inane barriers that block patients from obtaining or using telehealth.”
Many of those unnecessary barriers have been imposed at the state level, including requiring a patient and provider to be physically located in the same state or requiring a patient to travel to a specific telehealth site before connecting to a provider, limiting telehealth to specific technologies, and mandating that a patient have a pre-existing relationship with their doctor before a telehealth visit can take place. If all states joined interstate medical licensing compacts that provide reciprocity for mental health and other medical providers, many of these barriers would be removed, opening up access to care.
At the federal level, employers are unable to offer telehealth as an employee benefit, separate from health coverage, because the previous administration required telehealth benefits to be paired with a full medical benefit that meets all of the different Affordable Care Act requirements. However, employers often use a separate vendor to design and administer their telehealth benefits. Employers are not able to offer telehealth as a standalone option to anyone not enrolled in the full medical plan, effectively banning employers from extending telehealth to all populations.
ERIC’s testimony provided lawmakers with options they can put into place to expand telehealth access to all Americans and make it easier for employers to offer it as a benefit to their workforces:
- Designate standalone telehealth as an “excepted benefit” so that it can be offered to more patients
- Enable providers to practice telehealth across state lines
- Establish a simple set of federal standards for telehealth, eliminating state barriers
Additionally, ERIC addressed the issue of certain stakeholders asking Congress to implement telehealth changes that would eliminate competitive markets, promote low-value care, and reduce the potential for telehealth to be transformational for the medical system. ERIC’s testimony specifically called out the “Health Care at Home Act” that would mandate ERISA health plans to cover telehealth for any service that is covered in person, as well as mandate that payment for those services is the same whether provided via telehealth or in person. These changes fail to expand and improve telehealth and would instead uproot the blossoming competitive market telehealth represents. Further, the prospect of government imposition of a sweeping coverage mandate within ERISA plans would inject more unproven and potentially low-value care into employer-sponsored coverage. It would reduce the quality of coverage while increasing costs for participants.
“The federal government mandating payment rates between two private parties is not only an extreme break from precedent but wholly inappropriate. Current law allows for providers to negotiate telemedicine rates with payers, which has given rise to a thriving market in which competition drives cost efficiency, value, quality, and innovation. Losing this successful competitive market would be a significant setback for patients and employers, and ultimately for up-and-coming providers who otherwise could cultivate opportunities in the telehealth space,” said Gelfand.
Click here to read ERIC’s testimony.