GAO Urges Further CMS Analysis of Telehealth in Medicare While MedPAC to Analyze Telehealth Reimbursement by June 2023

Last week, the Government Accountability Office (GAO) released its long-anticipated report reviewing the use of telehealth in Medicare during the public health emergency (PHE) and making recommendations regarding what the Centers for Medicare & Medicaid Services (CMS) should consider before making decisions on permanent telehealth policy. At the same time, the Medicare Payment Advisory Commission (MedPAC) formally announced plans to complete its analysis of telehealth in Medicare by June 2023 as required by Congress.

AOTA staff and members Katie Jordan, OTD, OTR/L, FAOTA, University of Southern California; and Mary Walsh-Sterup, OTR/L, CHT, CN Rehab Services, spoke with GAO researchers in 2021 to discuss how occupational therapy services were being provided via telehealth during the PHE. While OT services are referenced in the statistics provided by GAO, the report’s recommendations centered on the need for CMS to evaluate further data, and the degree to which CMS’ current data collection should be enhanced.

Occupational therapy and other therapies represent only a small fraction of the services provided via telehealth in Medicare. Congress, however, must still act to allow occupational therapy practitioners (OTPs) to utilize telehealth on a permanent basis beyond the PHE and a 151-day waiver extension, which was already enacted. The MedPAC Report noted that waivers should be extended for a period of 1 or 2 years, and the House has already passed a bill that would extend telehealth waivers through 2024. The Senate, however, must still act before the current Congressional session ends in December, or the issue will need to be addressed again in 2023 by the incoming Congress.

AOTA remains focused on supporting the Expanded Telehealth Access Act (H.R. 2168/S.3193) which has attracted 71 House and 7 Senate co-sponsors. That bill would permanently enable OTPs to provide occupational therapy services to Medicare beneficiaries via telehealth. Legislation is essential because CMS does not have the authority to allow occupational therapists, occupational therapy assistants, or other therapy providers to provide services via telehealth after the PHE waivers expire. Although CMS has extended some OT telehealth CPT® codes through the end of 2023 regardless of the status of the PHE, without Congressional action no OTPs would be allowed to bill these codes, so occupational therapy services via telehealth would end for Medicare beneficiaries.