Health care providers fear cancellation of telehealth coverage after pandemic ceases

FAIRFAX, Va. — Meg Fregoso, a nurse practitioner, used to see patients who previously had a lung transplant at Inova Fairfax Hospital. Now she uses telehealth to meet patients.

Fregoso is one of many health care providers offering more telehealth services due to the COVID-19 pandemic. However, providers are concerned that they will no longer be reimbursed for these services once coronavirus restrictions are lifted.

The coverage of telehealth for physical therapy services was rare before COVID-19, according to Kara Gainer, director of regulatory affairs at the Alexandria-based American Physical Therapy Association. Now, Medicare and most insurance companies are covering more telehealth services due to the coronavirus, Gainer said.

Centers for Medicare & Medicaid Services expanded Medicare coverage due to COVID-19, according to the organization’s website. However, the agency will reduce payments, on Jan. 1, 2021, to more than three dozen categories of health care providers, according to APTA.

Challenges still remain for physical therapists as many are uncertain about payment, according to a survey done by the APTA.

Gainer works with different groups, such as the American Speech-Language-Hearing Association, to advocate for the continuation of coverage for health care providers.

“Everyone would be supportive of receiving reimbursement for telehealth services at the same rate as receiving reimbursement for in-person services,” Gainer said.

Reimbursement is the payment that health insurers send to health care providers for giving a medical service, according to an article by Verywell Health, a website that provides health information.

In the past, Inova considered using telehealth to treat post lung transplant patients, Fregoso said. However since most insurance providers didn’t reimburse this type of service, it wasn’t commonly used. Now, Fregoso and other providers are reimbursed for telehealth visits.

“With everything with COVID, it became kind of critical,” Fregoso said.

Telehealth uses technology like  messages, phone calls and live video conference meetings to provide health care services, according to the American Telemedicine Association.

Jade Bender-Burnett, a physical therapist who serves patients with spinal cord and brain injuries at NeuroPT in Falls Church, used telehealth to serve patients before COVID-19 and has continued to use it. Bender-Burnett spoke about how COVID-19 made telehealth more accessible.

“One of our biggest barriers to providing virtual treatment sessions has always been reimbursement,” Bender-Burnett said.

Some patients, like Kathy Lindsey, find telehealth appointments more beneficial than visiting the doctor in-person. Lindsey sees an endocrinologist in Fairfax County. She began using telehealth to see her endocrinologist because of COVID-19.

Given the option she would like to continue using telehealth services because it is convenient and efficient, Lindsey said.

Telehealth’s more prominent role in health care will make private insurance companies and Medicare likely continue to cover these services, according to Gainer. Congress will have to act to ensure continued coverage because the Centers for Medicare & Medicaid Services does not have the authority to make the coverage permanent, Gainer said.

Legislation has been introduced that would make telehealth coverage permanent for therapy providers, according to Gainer. It is likely the discussion regarding telehealth and introduction of other bills will occur in Congress in the coming months, Gainer said.

“The landscape is forever changed,” Gainer said.