Congressional Committee Leaders Introduce Legislation to Extend Telehealth Waivers for 2 Years Beyond PHE

Reps. Lloyd Doggett (D-TX), Devin Nunes (R-CA), and other House telehealth advocates have introduced the Telehealth Extension Act (H.R.6202), which would remove telehealth geographic and originating site restrictions permanently while extending other public health emergency (PHE) telehealth waiver provisions for 2 years after the formal end of the PHE. These waivers have enabled occupational therapy practitioners (OTPs) to provide services via telehealth to Medicare beneficiaries. This legislation would prevent an OT “telehealth cliff” while also enabling Congress to review data from the Centers for Medicare & Medicaid Services (CMS) and other sources regarding the use of telehealth beyond the pandemic to enact permanent policy changes for Medicare.

Rep. Doggett is the Chairman, and Rep. Nunes is the Ranking Member of the House Ways and Means Health Subcommittee, which has primary jurisdiction over Medicare telehealth policy. AOTA staff worked to ensure that H.R.6202 would continue the ability of both occupational therapists and occupational therapy assistants to utilize telehealth as appropriate after the PHE.

H.R.6202 would provide certainty regarding the use of telehealth beyond the PHE, which can only be renewed by the Department of Health and Human Services in 90-day increments. As of now, the PHE is slated to expire on January 16, 2022, and there is no guarantee that it will be extended, although most observers believe that further extension is likely, given the emergence of new COVID variants.

AOTA continues to work for passage of the Expanded Telehealth Access Act (H.R. 2168/S.3193) which has attracted 57 House and 4 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 it has proposed extending some OT telehealth CPT® codes through the end of 2023 regardless of the status of the PHE. Without Congressional action, however, no OTPs would be allowed to bill these codes, so occupational therapy services via telehealth would end for Medicare beneficiaries.

“The COVID-19 pandemic has demonstrated the effectiveness of occupational therapy delivered through telehealth and the importance of removing barriers to care,” observed Wendy C. Hildenbrand, PhD, MPH, OTR/L, FAOTA, President of the American Occupational Therapy Association (AOTA). She adds that, “telehealth has enabled occupational therapists and occupational therapy assistants to improve efficiency of care by minimizing therapy delays and missed appointments related to travel and access issues and improve outcomes by allowing visual access to a beneficiary’s home environment. Working with individuals virtually in their authentic home environment, occupational therapy practitioners can identify physical safety risks and contextual barriers to daily life performance which may not have been revealed otherwise. Occupational therapy through telehealth is now an essential part of health care.”

When the pandemic struck, Congress enacted legislation that enabled CMS to waive restrictions on occupational therapy practitioners’ and other therapy providers’ ability to provide Medicare services via telehealth. CMS responded by issuing an emergency rule that added a series of therapy CPT® codes to the telehealth services list, then subsequently issued another rule that included occupational therapy practitioners as eligible Medicare telehealth providers, once Congress enacted legislation allowing them to do so. This effectively enabled occupational therapists and occupational therapy assistants to provide services via telehealth to Part B Medicare beneficiaries during the COVID-19 emergency; however, these waivers are not permanent.

AOTA will continue to work with Congressional champions to ensure that occupational therapy is included when Congress addresses this issue. Contact Andy Bopp, abopp@aota.org with any questions.