Key Federal Legislation Sees Movement Prior to Summer Recess

Aug. 4, 2022 - Prior to Congress' adjournment for the August in-district work period, there was movement on several key pieces of legislation for which AAFP has been advocating.

On July 27, the U.S. House Ways and Means Committee approved, via bipartisan support, federal legislation (HR 8487) that calls for streamlining prior authorization processes in Medicare Advantage plans. Improving Seniors’ Timely Access to Care Act of 2022 removes barriers to care by requiring MA plans to, among other things:
  • Implement electronic prior authorization programs that adhere to newly developed federal standards
  • Establish real-time decision-making processes for “routinely approved” items/services
  • Issue accelerated decisions for all other services in Medicare Part C
  • Report to CMS on the extent of prior authorization use and rate of approvals and denials. HR 8487 now moves to the full House for consideration, which may take place when Congress returns from its August recess.
Also on July 27, the full body of the U.S. House of Representatives passed, by a vote of 416-12, the Advancing Telehealth Beyond COVID-19 Act (HR 4040). The bill now heads to the Senate.
If HR 4040 receives Senate approval and is signed into law by Pres. Biden, key waivers put in place to overcome barriers to Medicare telehealth reimbursement will continue through Dec. 2024. Telehealth flexibilities granted during the COVID-19 public health emergency (PHE) are currently scheduled to end in the coming months.
The bill provisions allow, among other things:
  • Beneficiaries to continue to receive telehealth services at any site, including a patient’s home, regardless of type or location
  • Federally qualified health centers and rural health clinics to continue to serve as the distant site
  • E&M and behavioral health services to continue to be provided via audio-only technology
Extending telehealth waivers beyond the COVID-19 PHE has been a big focus of AAFP’s advocacy work. In June, the Academy delivered new guidance to federal regulators—namely HHS Secretary Xavier Becerra and the U.S. Treasury, Labor, and Justice Departments—for “unwinding” associated PHE policy changes. AAFP's letter also called for the PHE to continue “through at least the end of calendar year 2022," and it underscroed that the primary goal of a telehealth extension plan must center on timely and affordable access to comprehensive care.