Telehealth Payment Parity Demanded By Illinois Medical Coalition

An Illinois medical coalition made of doctors, nurses and medical experts from across the state is calling on lawmakers to implement payment parity with telehealth services. The coalition has released a ten-point request that they hope will bring the approach to payments for telehealth services in line.

The request from the Illinois medical coalition was made earlier last month, in a letter sent to every member of the House of Representatives and other state officials.

Looking At The Overall Aims of The Illinois Medical Coalition

An increase in telehealth use during the pandemic has increased the focus on ensuring that all medical services costs are covered. The overall aim is to ensure that telehealth providers are compensated in the same way that in-person health providers are.

In a five-page letter, the Illinois medical coalition stated the following;

“Absent action from the Illinois General Assembly, providers will not have the certainty they need to continue to invest in and utilize new care delivery tools. Illinois residents will abruptly lose access to the telehealth services they have relied on during the pandemic.”

“To ensure continued investment in the most effective and efficient technologies and, moreover, patient access to telehealth services, providers, professionals and patients need assurance that key flexibilities authorized during the pandemic will continue beyond its end.”

A number of states have issued emergency orders to bridge the payment gap for telehealth services. This coalition, however, does not want only emergency measures but is instead looking for permanent action.

As we reported here, the CMS very quickly rolled out plans to cover more telehealth applications under Medicaid. These temporary steps need to be made permanent.

The ‘Linchpin’ In Removing Barriers For Patient Access

The Illinois medical coalition is very serious about its demands and has been outspoken on the need for speed on this issue. It is generally assumed that the switch to telehealth will increase in the coming years. The pandemic has expedited this process, and the onus is now on lawmakers to ensure a system is in place to take care of it.

The letter goes on to discuss the magnitude of these decisions;

“Payment parity is the linchpin to removing existing barriers to patient access and provider adoption, paving the way for the widespread implementation of telehealth.”

“By allowing insurers to negotiate separate in-person and telehealth payment rates, particularly as premiums continue to rise, insurers will profit at substantial expense to patients, providers, professionals, and employers.” 

Both Sides Need To Be Considered In the Telehealth Argument

Whilst Illinois has been praised for its swift action to increase telehealth services (a story we covered here), more work needs to be done on the payment side. It is unreasonable to increase services covered by telehealth providers, without making sure they are reimbursed.

The Illinois medical coalition recognizes the clear dangers which exist in not providing sufficient relief;

“Without telehealth coverage and payment parity for Medicaid and commercial insurance, Illinois health plans can reimburse providers at unsustainably low rates or choose not to cover services at all, stifling flexible access to services and investments in virtual technologies that have been rapidly adopted and accepted this year,” 

Early Indications of Funding Support

Given the force the Illinois medical coalition carries, we can expect to see some progress on this demand. The state has already shown its intention to support telehealth providers. We reported here on the announcement from Senators Duckworth and Durbin to fund seven telehealth providers with almost $2M of state money.

The feeling about the funding of this type, however, is that it is band-aid money. For real change, laws must be passed that are designed to protect telehealth providers across the state, now and in the future.

Given that just about every medical, group, organization, association, and union has backed this ten-point plan, we should all expect to see some real progress with this. Lawmakers simply cannot ignore this request, or the urgency of the need to make swift, comprehensive changes.