ACR Supports Continued Use of Telemedicine and Reimbursement Parity After COVID-19 Crisis

Once the coronavirus disease 2019 (COVID-19) public health emergency ends, telemedicine should continue to be used to increase access and improve care for patients with rheumatic diseases, according to a position statement released by the American College of Rheumatology (ACR). ACR’s position statement also supports continued parity of reimbursement for in-office visits, audio—visual visits, and audio-only visits after the pandemic.

ACR noted that practices have been able to combat the financial strain of reduced in-person visits during the COVID-19 pandemic through the adoption of telemedicine. Policy changes enacted by CMS due to the public health emergency has allowed clinicians to be reimbursed for telemedicine services at the same rate as in-person visits, and ACR supports continued parity reimbursement in order to “preserve the economic viability of rheumatology practices.”

“As providers plan for rheumatology care post-COVID, taking into consideration rheumatology workforce shortages and geographically distant patients, it is apparent that telemedicine could help rheumatology providers improve care models for their patients if the long-term economic and regulatory landscape remains favorable,” Chris Phillips, MD, one of the statement’s lead authors and member of the ACR’s Committee on Rheumatologic Care (CORC), said in a press release.

ACR noted that telemedicine should be used in conjunction with periodic in-person visits and should not replace essential face-to-face assessments. In addition, ACR stated that reimbursement parity should occur as long the provider—patient relationship includes both in-person and telemedicine services, patients have a choice of provider for telemedicine services, the standard and scope of care provided by telemedicine services is consistent with in-person services, and the provision of telemedicine services is properly documented.

The statement includes another 6 positions, most of which are supporting, as well as 2 opposing positions.

ACR also supports protecting the security and integrity of patient information, proposals that facilitate the interstate practice of telemedicine, outcomes-based research of telemedicine use in rheumatology, and continued access to telemedicine services even after the COVID-19 public health emergency ends. In addition, ACR recommends platforms with a way to obtain informed consent for the delivery of telemedicine services.

In the position statement, ACR opposes geographical restrictions on telemedicine practice and payer policies that would dictate use of specified telemedicine platforms, create restrictive networks, or use telemedicine as a way to divert patients to preferred providers.

“While telemedicine should not replace many of the hands-on skills and in-office assessments rheumatology professionals provide, patients in all areas of the U.S. should have access to telemedicine, regardless of location, and the services should be included in all subscriber benefits and insurance plans,” said Aruni Jayatilleke, MD, one of the statement’s lead authors and member of CORC. “Additionally, rheumatology professionals should be reimbursed equitably for telemedicine services and have access to a streamlined state medical license process.”

For information on all 8 positions, read the full statement.