May 20, 2021
Senate Finance Committee hearing on COVID-19 health care flexibilities
On May 19, the Senate Finance Committee held a hearing entitled, "COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned." The committee primarily focused on telehealth flexibilities made available during the public health emergency and discussed with the panel which policies should be made permanent, as well as how to assess key questions of cost, quality, access and equity.
Among the telehealth issues discussed, the committee focused on the "digital divide" and the need to build up infrastructure for rural areas that lack access to broadband, while also questioning the panel on the need for audio-only telehealth for underserved populations and the concern over creating a "two-tiered system." Several panelists noted their support for audio-only services not only for underserved communities but also as a stop-gap when technologies fail, as a choice for consumers, and as an additional "tool in the toolbox" as part of the care continuum. The panel also noted the importance of permanently waiving geographic restrictions to ensure access in rural communities, expand the ability to remotely prescribe buprenorphine and manage substance use disorder via telehealth, and the need to explore alternative payment models after the initial steps taken by the committee on the issue.
The committee and panelists also expressed support for expansions of Hospitals at Home waivers, revisiting the Skilled Nursing Facility 3-Day Rule, easier access to audiologists in the Medicare programs without a referral, and first dollar coverage of virtual care for beneficiaries with high-deductible health plans (HDHPs). Senators Steve Daines (R-MT) and Catherine Cortez Masto (D-NV) announced their bill, the Telehealth Expansion Act of 2021, which would to permanently allow first dollar coverage of virtual care under HDHPs.
In closing the hearing, Chairman Ron Wyden (D-OR) called telehealth a "godsend" for people who could get access to it and noted the need to sort out some bureaucratic issues given the speed at which the flexibilities were enacted, adding that the question of equity is fundamental to their path forward. Ranking member Mike Crapo (R-ID) expressed his strong support for extension of many of the pandemic flexibilities on a permanent basis, and in particular for the telehealth flexibilities.
Additional information is available in the attached Tax Alert.
Hearing on COVID-19 health care flexibilities