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Policy background information

Telehealth and Access to Dermatology Services


To expand access to dermatologic care, the American Academy of Dermatology Association (AADA) supports the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act (H.R. 4932/S. 2741), which lifts certain restrictions on telehealth, while maintaining the viability of in-person care when available.

Furthermore, much about telehealth can be gleaned from how and by whom it has been used during the COVID-19 public health emergency (PHE). The Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020 (H.R. 7233) addresses this need and calls for a study of the telehealth outcomes during the PHE.

Message to Capitol Hill

Telehealth is a viable option to deliver high-quality care to patients. Dermatologists have championed several teledermatology initiatives to increase access to board-certified dermatological care and the CONNECT for Health Act aligns with those beliefs.

The AADA is a leader in providing high-quality dermatology care via remote and virtual modalities. In fact, dermatologists volunteer to participate in AccessDerm, which is a program that improves access to teledermatology from board-certified dermatologists at no charge to eligible under-served clinical sites.

The CONNECT for Health Act could open the doors for our members to integrate telehealth in their every-day practice, increasing participation across the specialty as opposed to a small volunteer program that benefits only a few. Our support for certain provisions within the CONNECT for Health Act rests on the following:

  • Adequate coverage: The AADA believes that to have appropriate coverage and payment for telehealth services, physicians delivering teledermatology services must be licensed in the State in which the patient receives services and must abide by that State’s licensure, scope of practice and medical practice laws.

  • Flexible restrictions: The AADA supports providing the Secretary of Health and Human Services (HHS) the option to waive geographically based coverage restrictions if it is deemed that it would not deny or limit the coverage or provision of benefits. Removing the geographic barriers at Federally Qualified Health Centers, rural health clinics and Indian Health Service facilities will help provide critical dermatologic services to underserved patient populations.

  • Patient choice: The AADA supports preserving the patient’s choice by having access to both in-person and virtual dermatology services. For example, there are some skin diagnoses where an in-person examination by a dermatologist provides additional information that may not otherwise be obtainable by teledermatology alone. Therefore, it is important to ensure that by expanding access to telehealth services that payers, including, but not limited to, traditional Medicare and Medicare Advantage, do not create unintended barriers to quality care by limiting in-person interactions between the patient and physician.

Additionally, the AADA supports the KEEP Telehealth Options Act of 2020 call for the collection of demographic data and examination of differing patient groups, including underserved populations and communities, to ensure that telehealth narrows the gap in health disparities and adequately addresses social determinants of health. This proposal is timely due to the massive increase in telehealth usage by dermatologists during the public health emergency. Among dermatologists surveyed by the AADA, the use of telehealth grew from 9% pre-PHE to 90% in the months following. To help shape future policy, the AADA supports the studies called for in the KEEP Telehealth Act. More so, we believe that the results of these studies could help health policy makers remove barriers to care for underserved populations in urban and rural areas.

Asks

  1. Cosponsor and support passage of the CONNECT for Health Act (H.R. 4932/S, 2741) prior to the close of the 116th Congress.

    Background
    Introduced by Reps. Mike Thompson, D-CA, Peter Welch, D-VT, Bill Johnson, R-OH, David Schweikert, R-AZ, and Doris Matsui, D-CA, in the House and by Senators Brian Schatz, D-HI, Roger Wicker, R-MS, Ben Cardin, D-MD, John Thune, R-SD, Mark Warner, D-VA, and Cindy Hyde-Smith, R-MS in the Senate, the CONNECT for Health Act (H.R. 4932/S. 2741) would give the Secretary of HHS the options to:

    • waive coverage restrictions if it is deemed that it would not deny or limit the coverage or provision of benefits,
    • remove geographic restrictions and adds the home as an originating site for mental health services,
    • removes geographic barriers at Federally Qualified Health Centers, rural health clinics and Indian Health Services,
    • require CMS’ payment review process to add telehealth services to better consider how telehealth can improve access to care, and
    • require an analysis of the impact of telehealth waivers in CMS Innovation Center models.

  2. Cosponsor and support passage of the KEEP Telehealth Options Act (H.R. 7233) prior to the close of the 116th Congress.

    Background
    Introduced by Representatives Troy Balderson, R-OH, and Cindy Axne, D-IA, the KEEP Telehealth Options Act (H.R. 7233) would require the Department of Health and Human Services (HHS) and the Government Accountability Office (GAO) to report on the availability and effects of expanded telehealth services under Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) during the COVID-19 PHE. Among other information, HHS must detail its actions during the emergency to expand access to telehealth services and must analyze telehealth usage by certain demographic groups. The GAO must report on the efficiency and management of the telehealth expansion and related risks of fraudulent activity.

More information

The Academy has a robust telehealth webpage offering information on the latest laws, advocacy actions, more details on AccessDerm, and a toolkit for practices. Learn more.


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