March 6, 2022

The Honorable Mariannette Miller-Meeks
United States House of Representatives
1716 Longworth House Office Building
Washington, DC 20515

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The Honorable Mike Kelly
United States House of Representatives
1707 Longworth House Office Building
Washington, DC 20515

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The Honorable Morgan Griffith
United States House of Representatives
2202 Rayburn House Office Building
Washington, DC 20515

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RE: The Modernization Subcommittee of the Healthy Futures Task Force Request for Information (RFI)

Dear Representatives Miller-Meeks, Kelly, and Griffith,

CEO Action for Racial Equity (CEOARE) is pleased to respond to the Modernization Subcommittee’s RFI and provide input on the expansion of telemedicine and digital health. CEOARE is a national fellowship composed of over 100 companies that mobilizes communities of business leaders with diverse expertise, across multiple industries and geographies, to advance public policy in four key areas — healthcare, education, economic empowerment, and public safety. Our mission is to identify, develop, and promote scalable and sustainable public policies and corporate engagement strategies that address systemic racism, social injustice, and improve societal well-being.

We commend the Healthy Futures Task Force on its mission to examine the efficacy and efficiency of expanded telemedicine to appropriately address barriers to access, affordability, and quality of care.

We write to provide specific input on flexibilities created under the COVID-19 public health emergency (PHE) that CEOARE believes should be made permanent. We urge Congress to capitalize on this opportunity to extend the innovative delivery models that were implemented during the PHE to modernize the U.S. health care system and expand critical healthcare access.

Response to Telemedicine Expansion Question: Which flexibilities created under the COVID-19 PHE should be made permanent?

CEOARE supports the permanence of telehealth flexibilities provided through the U.S. Department of Health and Human Services (HHS) during the COVID-19 PHE, which have been instrumental in providing critical access to care for many vulnerable Americans.

Specifically, we recommend the permanent removal of geographic eligibility requirements and originating site restrictions in the Medicare program to confirm that individuals are able to access timely telehealth services regardless of where they reside. Currently, HHS can waive these restrictions only under PHE authority. This means that at the end of the current PHE, absent an act of Congress, millions of Americans currently receiving Medicare telehealth services would lose the ability to receive these services at home, and many would lose the ability to access telehealth services at all based on where they live. It is up to Congress to act to confirm that these services remain and that we do not lose the progress that was made over the last two years. As a result, we strongly encourage this Subcommittee to support the permanent removal of Section 1834(m) geographic and originating-site restrictions to protect access to telehealth care.

Additionally, during the COVID-19 pandemic, community providers, including Federally Qualified Health Centers and Rural Health Clinics, have been instrumental in providing much needed telehealth services to underserved populations serving as distant sites. We encourage the Subcommittee to support the continuation of this policy beyond the PHE, allowing these clinics to continue serving vulnerable populations, and confirm that these providers are appropriately reimbursed.

In addition to these permanent changes, we recommend that the Subcommittee consider the extension of the remaining telehealth waivers offered under the PHE until sufficient data can be collected and used to inform permanent policies. We also urge the Subcommittee to support the removal of federal in-person requirements for telehealth services, particularly as they apply to behavioral and mental health services. Telehealth has proven to be especially vital for individuals in need of behavioral and mental health services during the extraordinarily disruptive circumstances of the COVID-19 pandemic. We commend Congress for taking action to permanently incorporate telemental health into the Medicare program for the delivery of behavioral and mental health services. However, federal in-person requirements present access barriers for many who reside in areas where behavioral and mental health specialty providers may not be readily available for a mandatory in-person visit. Therefore, we encourage the Subcommittee to support the repeal of these federal requirements in favor of a more evidence-based, clinically responsive approach.

CEOARE believes that Congress is well positioned to guide our health care system towards a future with healthier Americans through greater modernization and affordability of care. The needs of our vulnerable citizens and their health outcomes must be present in consideration of where and how health services and products are designed, distributed, and accessed.

Thank you for the opportunity to respond to this RFI and for the greater efforts pursuing informed decision-making around telemedicine and digital health. If you have any questions or would like to follow up on any of the items discussed in this letter, please do not hesitate to contact Roz Brooks via email at roslyn.g.brooks@ceoactionracialequity.com.

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Sincerely,

CEO Action for Racial Equity