AHA Letter of Support for House CONNECT Health Act of 2023 (H.R. 4189)

October 10, 2023

Dear Representatives Thompson, Matsui, Johnson and Schweikert:

On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, the American Hospital Association (AHA) writes in support of the CONNECT for Health Act of 2023 (S. 2016/H.R. 4189).

At the outset of the COVID-19 pandemic, the federal government moved quickly to ensure hospitals and health systems were able to respond efficiently and effectively to a wave of unprecedented need. The Centers for Medicare & Medicaid Services waived certain regulatory requirements and Congress provided significant legislative support to ensure hospitals and health systems could manage the numerous challenges facing them, including by increased virtual care options. These swift actions provided hospitals and health systems with critical flexibilities to care for patients during what has been a prolonged and unpredictable pandemic. We appreciate the introduction of this bill, which proposes many changes that would allow for increased patient access to telehealth services and use by hospitals and other providers, while removing barriers to adoption.

Patients across geographies and settings, including both rural and urban areas, have benefited from increased access and improved convenience provided by telehealth services. Specifically, we strongly support the provision in the legislation which would permanently remove the geographic restrictions that currently limit where patients can access telehealth services and would add homes and other clinically appropriate sites as eligible originating site locations. We would encourage consideration of simply eliminating originating site restrictions altogether. Doing so would ensure that all Medicare beneficiaries can access services regardless of where they and their providers are physically located.

Behavioral health is one specialty area that has seen sustained growth in telehealth utilization. In fact, prior to the pandemic, telehealth visits accounted for less than 1% of behavioral health visits. During the pandemic, they peaked at about 40% of all behavioral health visits and have been sustained at around 36%.¹ Geographically dispersed patients have benefited from increased access to behavioral health services provided through telehealth, especially in areas that may have provider shortages and in person visits are not possible. As a result, we appreciate the proposed removal of the requirements that a patient must receive an in-person evaluation six months before they can initiate behavioral telehealth treatment and also must have an in-person visit annually thereafter.

Additionally, the AHA supports allowing rural health clinics and federally qualified health centers to serve as distant sites, so that these facilities may use the providers at their own sites to offer care to patients, ensuring patients remain connected to their primary providers. The AHA also supports allowing critical access hospitals (CAHs) the same ability to offer and bill for telehealth services and would encourage consideration of adding language to include CAHs as eligible distant sites.

We also appreciate the ability to waive restrictions on the use of telehealth during national and public health emergencies and support improving Medicare’s process for coverage of telehealth services given the positive impact of improving patient’s access to care.

Hospitals, health systems, providers and patients have seen the benefits and potential for telehealth to increase access and transform care delivery. We appreciate your leadership on this important issue and look forward to working together to ensure passage of the CONNECT for Health Act of 2023.

Sincerely,

/s/

Lisa Kidder Hrobsky
Senior Vice President
Advocacy and Political Affairs
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¹ Telehealth Has Played an Outsized Role Meeting Mental Health Needs During the COVID-19 Pandemic | KFF