HEALTH CARE AND TELEHEALTH

By Bob Katzen

The House 157-0, Senate 40-0, approved and sent to Gov. Baker a conference committee report of a bill that sponsors say will increase access to health care, protect patients and enhance quality care. The bill requires behavioral health treatment delivered via telehealth to be permanently reimbursed by insurers at the same rate as in-person services.

A similar reimbursement structure will also be implemented for primary care and chronic disease management services delivered via telehealth for two years. All other telehealth care services will be reimbursed at the same rate as in-person services for the duration of the COVID-19 state of emergency, and 90 days after its expiration.

It also eliminates “surprise billing,” the much-criticized practice of charging unsuspecting patients who received health care services outside of their insurance plan’s network for costs that insurers refuse to pay.

Other provisions would allow registered nurse practitioners, nurse anesthetists and psychiatric nurse mental health specialists who meet specific education and training standards to practice independently; recognize pharmacists as health care providers, enabling them to integrate more fully into coordinated care teams; allow Massachusetts optometrists to treat glaucoma; and ensure that critical services related to treatment of COVID-19 would be covered by insurance carriers, including MassHealth, at no cost to consumers.

“[We are] pleased the House and Senate conference committee finalized a health care bill that takes important steps to protect consumers and ensure access to health care services during the COVID-19 pandemic and beyond,” said Amy Rosenthal, Executive Director of Health Care For All. “We commend legislative leaders for making progress on important policies that are critical to the health and health care of millions of Massachusetts residents, and we thank the conferees for their work during a very challenging time.”

“This conference committee report embraces the best of both the Senate and House bills to create comprehensive and necessary healthcare reforms,” said Sen. Cindy Friedman (D-Arlington), Senate chair of the Committee on Health Care Financing. “While there is still more to do to improve patient outcomes and access to care, this bill takes a meaningful step forward by ensuring that the commonwealth’s healthcare system can continue to meet the needs of patients during this unprecedented time, and long after the COVID-19 pandemic has ended.”

“The conference report continues to advance our goal of transforming mental health care access and delivery in Massachusetts,” said Sen. Julian Cyr (D-Truro), House chair of the Joint Committee on Mental Health, Substance Use and Recovery. “This legislation will do so much good, but particularly it will expand mental health care access for rural residents, people of color, working families, and young people.”

Lora Pellegrini, President of the Massachusetts Association of Health Plans (MAHP) said the group is a strong supporter of ensuring telehealth services for the members and the employers it serves. “Telehealth has been an important tool to ensure members have continued access to provider services during closures associated with the COVID-19 pandemic. In order for telehealth to truly deliver on its promise of increased access to high-quality care at lower costs, it is imperative that market-based negotiations set the reimbursement rate and any extension of mandated rates of payment be time-limited. We applaud the conference committee for ensuring that some telehealth services can be negotiated after the current state of emergency, but we are concerned that it will require health plans to reimburse for other services at the same rate as in-person visits for two years.”

“While we are pleased with other provisions in the bill, such as the increased Medicaid payment rates for community hospitals, MAHP is disappointed that the final conference agreement did not address the well-documented and growing concern of surprise billing in a comprehensive way,” continued Pellegrini. “Congress passed legislation which may result in higher premiums for employers and consumers, making it more important than ever that the Massachusetts Legislature establish a policy for out of network providers that is fair, but does not provide an excessive rate of payment. We look forward to working with the House and Senate on this important issue in the next session.”

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