Letter to the Hon. Thomas McCaffery, Assistant Secretary of Defense for Health Affairs - Congresswoman Luria Calls on Defense Health Agency to Cover Mental Telehealth Services Under TRICARE

Letter

Dear Mr. McCaffery,
The undersigned Members of Congress urge the Department of Defense's Defense Health Agency (DHA) to permit telehealth services under TRICARE during the COVID-19 National State of Emergency, including telemental health services at all outpatient levels of care, such as intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs), and ensure payment parity for telehealth visits.
The Centers for Disease Control and Prevention (CDC) recommends the increased use of telehealth services in response to the COVID-19 pandemic as an alternative to face-to-face interactions in order to limit the transmission of the virus, protect the health of patients and healthcare professionals, and reduce the hospital
admission surge.

The Centers for Medicare & Medicaid Services (CMS) has already taken steps to expand the availability of telehealth services during this pandemic. Recent guidance from CMS substantially loosened restrictions surrounding telehealth services, permitting Medicare to pay for office, hospital, audio-only, and other healthcare visits furnished via telehealth, including mental health counseling.
However, TRICARE currently only permits military members and their families battling serious mental illnesses to access more intensive outpatient treatment like PHP in-person, forcing beneficiaries to choose between protecting their physical health and receiving mental health treatment. Until recently, IOP services were treated in the same manner. We applaud the recent guidance indicating inclusion of IOP telehealth coverage under TRICARE and encourage you to work expeditiously with providers to adjust services and promptly make beneficiaries aware of the new offering.
Left untreated, mental illness doubles a person's risk of a heart attack and stroke amongst other comorbidities, increases Emergency Rooms admissions, and enhances risk factors for suicide with 90% of suicides directly attributable to untreated mental illness.4 This, combined with a surge in anxiety and depression stemming from COVID-19, necessitates that steps be taken to ensure that military members and their families affected by mental illness are able to remotely access mental health care while protecting their physical health.
We urge DHA to implement similar measures as CMS through expanded telehealth services for all levels of care while ensuring payment parity for telehealth services. Servicemembers and their families deserve access to the safest care, and right now that means access to telehealth services.