By Pamela Greenberg, President and CEO, and Angela Lee, Director of Communications and Programs, ABHW
Congress recently returned from its August recess, and it is imperative that they prioritize making permanent or extending the telehealth flexibilities for mental health and substance use disorder care and, in particular, eliminating the in-person requirement for telemental health services in Medicare.
In December 2020, to make telemental health services more accessible, Congress removed the geographic and originating site restrictions for Medicare mental health services, allowing beneficiaries across the country to receive virtual care from their chosen location. However, in a counter move, Congress also imposed a new, never-imposed-before condition that requires Medicare patients who seek care for a mental illness to have an in-person visit no less than six months before they can receive mental health services via telehealth. Fortunately, application of this discriminatory requirement was delayed until January 1, 2025.
According to the Kaiser Family Foundation, up to 25% of adults age 65 and older are living with a mental health condition, and the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Academy of Medicine report that less than half of older adults with mental health and substance use disorders receive treatment. Not to mention that 160 million Americans live in areas with behavioral health workforce shortages. With the great need for care and the vast behavioral health workforce shortage, we urge Congress to remove this barrier on seniors seeking mental health care.
The acceptance and increase in usage of telemental health care has helped transform the behavioral health treatment landscape, increased access, and offered new opportunities to address behavioral illness more effectively and inclusively. Many behavioral health providers are attracted to the flexibility telehealth brings to their practice — accommodating work hours, no commute time, and the ability to serve a more diverse patient population. Health plans have expanded and diversified their networks, thus providing greater access to their members.
Medicare beneficiaries who previously had no local treatment options can now receive treatment in their chosen location and have continuity of care with their therapist whether they are sunning themselves in Florida or visiting their grandchildren in Washington, DC. Seniors who fear the stigma they may face if their neighbor sees them walking through the mental health clinic door can receive treatment in the privacy of their own homes. Patients who couldn’t find a provider who looked like them in their community can now find one online. Congress should eliminate barriers to medically necessary, evidence-based telemental health care rather than allowing an impediment that only applies to mental health care for Medicare beneficiaries.
If Congress doesn’t act in the next few months and allows the in-person visit requirement to go into effect, seniors will have to find a provider to visit in-person before they can receive audio/visual care. This could mean also having to find someone to drive them 90 minutes to the provider’s office, pay multiple copayments, wait weeks for an appointment, see a provider they can’t relate to, or forgo treatment altogether.
Congress, please ACT NOW. Don’t further disrupt the mental health crisis by imposing barriers to mental health care for Medicare beneficiaries by requiring an in-person visit prior to a telemental health care appointment.
