Telehealth: A Comprehensive Advocacy Strategy
By: Eugene Y. Rhee, MD, MBA | Posted on: 29 Jan 2021
FROM THE Public Policy Council
Public policy is a course of action created and/or enacted, typically by a government, in response to public, real-world problems. 1
Over the course of 9 months, the urology community has come upon real-world problems that are generational in scope. Whether practices be academic, employed, independent groups or solo, an overarching request has been heard from all: take action to advocate for telehealth for the delivery of urological care on behalf of practices and patients across this nation.
The AUA and its Urology Telehealth Task Force has formulated a comprehensive telehealth strategy engaging the Coding and Reimbursement, Legislative Affairs, Practice Management, Research Advocacy and State Advocacy Committees, and National Insurer Advisory, Veterans Health and Workforce Workgroups.
Additionally, several professional societies are already a part of this multipronged strategy, including The R. Frank Jones Urological Society, Sexual Medicine Society of North America, the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction, American Association of Clinical Urologists, and Large Urology Group Practice Association.
Telehealth was a key advocacy topic during the virtual Annual Urology Advocacy Summit Meeting. AUA members, representing 34 states and the District of Columbia, participated in more than 160 virtual meetings with lawmakers and staff to support legislation to make telehealth change permanent, advocating Congress and CMS (Centers for Medicare & Medicaid Services) to preserve Medicare beneficiary access to telehealth services. Telehealth is also a priority legislative issue for AUAPAC ( https://www.myauapac.org/).
On September 17, 2020, the AUA met virtually with CMS, thanking the agency for the flexibilities that have been made in response to the COVID-19 pandemic. Participating urologists spoke to proposing additional changes to Medicare's telehealth and communications technology based services policies, including virtual check-ins and audio-only E/M (evaluation and management) visits.
Partnering with the Alliance of Specialty Medicine has also brought forward language to seek permanence for urology in telehealth. Specifically,
- Maintain the updated Medicare telehealth list to retain all of the services added in response to the Public Health Emergency for COVID-19, including audio-only interactions
- Eliminate site-of-service payment differentials for telehealth visits, and maintain Medicare coverage and enhanced payment for “telephone” E/M services (CPT 9944–99443)
- Allow key telehealth and virtual care services (eg virtual check-ins, e-visits and other communication technology based services) to be furnished to both new and established patients
- Encourage state Medicaid programs and private payers to reimburse providers for telehealth services in the same manner or at the same rate that they pay for face-to-face services
- Eliminate Medicare and federal Medicaid requirements that require a physician to be licensed in the state in which he or she is practicing (provided the physician is licensed in the state associated with his or her Medicare enrollment) in order to facilitate practicing across state lines
- Preserve direct supervision revisions that allow physicians to supervise in-office clinical staff using communications technologies, when appropriate.
AUA telehealth advocacy is comprehensive, highlighting urology's guiding compass of access while assuring quality, satisfaction and affordability. We all are bearing witness to the course of action defined as public policy by your active participation in telehealth.
- Rinfret SR, Scheberle DL and Pautz MC: The policy process and policy theories. In: Public Policy: A Concise Introduction. Thousand Oaks, California: SAGE Publications 2018; chapt 2, pp 19-44.