On August 3, 2020, President Trump signed an Executive Order that could potentially extend the easing of restrictions on telemedicine that were put in place during the COVID-19 public health emergency (PHE) beyond the pandemic and increase access to care in rural areas.

Telemedicine use has rapidly accelerated during the pandemic. A recent HHS study found that Medicare beneficiaries’ frequency of telehealth primary care visits increased from less than one percent in February to over forty percent in April. CMS also performed an internal analysis showing a dramatic increase in Medicare beneficiaries’ use of telemedicine services. In all, over 10.1 million Medicare beneficiaries received a telemedicine service between March and July 2020.

To decrease the need for patients to seek in-person care, CMS implemented several measures during the PHE that have made telemedicine a viable alternative to in-person care for Medicare beneficiaries. Using its 1135 waiver authority, CMS lifted geographic and site of service restrictions permitting Medicare beneficiaries to receive services at home, and also expanded the types of providers that are permitted to use telemedicine to deliver care. CMS also used its emergency rulemaking authority to expand the types of services that could be delivered using telemedicine. The Executive Order has tasked the Secretary of HHS with reviewing the measures put in place during the PHE and proposing a regulation in the next 60 days that would extend these telemedicine flexibilities beyond the PHE.

In addition to expanding telemedicine capabilities, the Executive Order also addresses access to care in rural communities. The Executive Order directs the Secretary of HHS to submit a report outlining policy initiatives, past and future, that address maternal mortality, mental health, and barriers to care in rural communities, including regulations that limit provider availability in rural areas. The Secretary of HHS and Secretary of Agriculture are also directed to work with the FCC and other agencies to improve the communications infrastructure in rural communities. In addition, the Secretary of HHS will announce a new payment model pursuant to Section 1115A of the Social Security Act that permits rural providers to have more flexibility from the Medicare rules, with the goal of ensuring that providers receive adequate and consistent reimbursement.