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THE ISSUE
Telehealth is an important resource for connecting patients to vital health care services. Telehealth helps provide better health outcomes, more patient choice and greater health access to people across the country. The COVID-19 pandemic demonstrated the profound impact greater access to telehealth can have for millions of Americans across the country. Telehealth connects patients to a range of health care services through videoconferencing, remote monitoring, electronic consults, and wireless communications. Through telehealth, health care providers can help ensure patients receive the care they need, when they need it, while also providing greater access to health care consultations with specialists for those living in rural and low-income communities. Telehealth is therefore a critical tool in promoting greater health access and equity, particularly for low-income and vulnerable communities.

As part of the Consolidated Appropriations act of 2023, Congress provided a two-year extension of the current COVID-19 telehealth flexibilities (through 2024). These flexibilities include, removing geographic and originating site restrictions, expanding practitioners eligible to furnish telehealth services, expanding telehealth services for Federally Qualified Health Centers and rural health clinics, delaying the in-person requirement under Medicare for mental health services furnished through telehealth, allowing for audio-only telehealth services, allowing the use of telehealth for the recertification of hospice care, extends acute hospital care at home initiative and extends the safe harbor to allow employ health insurance plans to cover telehealth services pre-deductible or individuals with a high deductive health plans.

These temporary flexibilities provided by federal and state policy makers during COVID-19 have played a critical role in meeting health care needs during the pandemic. The flexibilities allowed health care workers and patients to stay safe while still having access to real-time health care and support. The lessons learned from the pandemic provided an opportunity for policy makers to build on the successes of these policies and an opportunity. However, without action from Congress millions of people risk losing access in two years to the care they value, such as mental health care prescriptions drugs and more.

MINISTRY TRADITION
For decades CHA and our members have carried the message that health care is a basic human right, essential to human flourishing, and we have advocated policies to ensure that everyone has access to affordable health care. We are inspired by the wisdom of the social doctrine of the Church, which teaches that each person is created in the image of God; that each human life is sacred and possesses inalienable worth; and that health care is essential to promoting and protecting the inherent dignity of every individual. CHA therefore supports innovative policy approaches for delivering care to improve access and outcomes while reducing costs through greater integration, coordination, prevention and use of emerging technologies such as telehealth. Telehealth plays a critical role in supporting efforts to responsibly steward new provide more affordable and accessible health care coverage, particularly to low-income and vulnerable communities.

CHA'S POSITION AND ACTIVITIES
Catholic hospital and long-term care providers have long been at the forefront of providing innovative services for meeting community health needs. Telehealth provides an increasingly important means of ensuring more people have affordable and quality health care, regardless of geography or social and economic barriers. CHA therefore advocates for telehealth policies which support local health care providers' efforts to expand telehealth services to more people across the country. CHA also supports a number of short and long-term policy changes to ensure greater access to quality and affordable telehealth services. These policy changes include:

• Telehealth COVID-19 Flexibilities –CHA continues to urge Congress and the Administration to make the extended telehealth flexibilities permanent.
• Eliminate geographic and originating site restrictions – CHA urges Congress to permanently revise the geographic and originating site restrictions to allow patients to receive telehealth services regardless of geographic location or originating site restrictions. Under section 1834(M) of the Social Security Act, telehealth services are restricted to designated rural areas of the country and specific physical locations, such as hospitals and physician offices. While the current two-year flexibilities allow providers to deliver telehealth services to patients in their homes and across greater locations, this critical flexibility will be lost if congress fails to act before the end of 2024.
• Expand access to broadband telecommunications services – Telehealth plays a critical role in providing a means for accessing health care services, however, lack of broadband access and end-user technology continues to create barriers for low-income and rural communities. CHA supports continued investment in affordable broadband access programs to reach low-income, rural, and underserved populations.
• Permanently extend payment for audio-only evaluation and management services - Prior to the COVID-19 public health emergency, CMS defined telehealth as "the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment." During the public health emergency CMS provided a waiver to establish a separate payment audio-only evaluation and management services. Through this waiver, over 3 million individuals who lack adequate broadband services or are uncomfortable with using audio-video telecommunications devices were able to access telehealth services. Permanently providing audio-only reimbursement will ensure millions of Americans continue to have access to the benefits of telehealth services regardless of location.
• Provide adequate reimbursement for telehealth and other virtual services - adequate reimbursement for telehealth services is critical for providing front line health care providers the resources they need to continue to expand telehealth services to all communities. Adequate reimbursement helps cover the substantial upfront costs of establishing and maintain telehealth virtual services. It also helps address the necessary privacy protections, patient education and ongoing training of the telehealth platform.
• Expand types of providers eligible to deliver telehealth services and provide parity in coverage for mental health and substance abuse services – Ensuring all medical professionals have the ability to be reimbursed for telehealth services is critical for ensuring an adequate access for those in need of non-physician health specialists, such as physical therapists, occupational therapists or speech pathologists. Similarly providing parity for reimbursement for mental health and substance abuse services in public and private reimbursements provide a critical resource for ensuring individuals have access to treatment – particularly in areas where these specializations are unaffordable or in accessible to many in need. CHA therefore supports permanently expanding the medical professionals eligible for providing telehealth services and ensuring parity in coverage for mental health and substance abuse telehealth services.