Telemedicine is here to stay, but how it will be covered by insurance is still being debated | Expert Opinion
What will happen once the current temporary pandemic telemedicine coverage expires? Will my insurance pay for the full coverage?
“No show.” This is one of the common notifications I’ve seen in clinic. There are so many thoughts that come to mind: Is the patient okay? Have they been admitted to the hospital? Did they have to go to the emergency room? Were there life circumstances or barriers in which they could not access care? I may never know the many challenges patients face that make it difficult to get to their appointment.
One thing we have learned is that patients do tend to make it more frequently to telemedicine sessions. Could the convenience of being able to pick up their smartphone, tablet, or computer, wherever they may be, play into this success? As one of my telemedicine patients said: “I’m glad I could talk to you all on video because I have my 6-month-old at home … I’m unable to get out of the house, and I don’t have childcare.” In this instance, a patient’s complicated life circumstance has been improved by telemedicine.
The stories and challenges are different, but the COVID-19 pandemic has taught us that telemedicine is here to stay. But how this service will be covered by insurance is still being debated. The Centers for Medicare and Medicaid have established guidelines for telemedicine insurance coverage. Coverage is also established at the State level. Providers and patients will be wrestling with questions about future changes in coverage and how this will impact patient care. What will happen once the current temporary pandemic telemedicine coverage expires, will my insurance pay for the full coverage? Will I be able to still see my Nurse Practitioner, Physician Assistant, or my own family physician or specialist via telemedicine?
The Pennsylvania State Senate Bill, introduced by Sen. Elder Vogel, Jr., will establish the infrastructure for telemedicine coverage reimbursement, define what healthcare personnel could provide these services, and mandate for full insurance reimbursement of telemedicine services, the same as an in-person visit. It is currently on its third Session amendment, but it is yet to be signed and approved by Governor Wolf. How many more state Senate Sessions will this bill take for it to be approved?
This bill is essential and there is a sense of urgency as many patients, as well as health care providers are counting on its final approval. The COVID-19 pandemic has shed light on how significant telemedicine services are for patients who are otherwise unable to make an in-person appointment. Let’s start turning the clinic visits from “No show” into a “Visit in Progress.”
Additionally, my colleagues and I wrote a prior article for the Philadelphia Inquirer regarding many people who “still lack access to fixed broadband service at threshold speed”. For telemedicine services to continue to benefit our state’s population, we need to expand the broadband infrastructure to these “digital deserts” and not leave those in need of telemedicine services out of the equation. I was happy to see progress being made in this area last year when Comcast offered free internet services to 35,000 Philadelphia families.
In recognizing the significant value of telemedicine to some of our most vulnerable patients, I urge Pennsylvanians to contact your State Representatives, including Senator Vogel, in support of the passage of our State’s Telemedicine Act, Senate Bill 705. Not only will we continue to enhance the future of our healthcare delivery system, but we will be joining several other states who have already passed their own Telemedicine Act. It’s time to come together as a community to support the health of those around us, essentially creating a healthier society for all.
Rolando Vega is a student at the University of Pennsylvania School of Nursing’s MSN Adult-Gerontology Primary Care Nurse Practitioner Program.