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Statements on Introduced Bills and Joint Resolution

Floor Speech

Date: Oct. 23, 2020
Location: Washington, DC


Ms. COLLINS. Mr. President, I rise today. along with my colleague Senator Cardin, to introduce the Home Health Emergency Access to Telehealth Act or Heat Act. This bipartisan bill would help ensure that seniors who rely on home health care have the choice to receive these critical services through telehealth during the COVID-19 pandemic and future public health emergencies.

COVID-19 is the greatest public health challenge since the flu pandemic of 1918 and has claimed the lives of more than 200,000 Americans. This public health emergency has underscored the need for older adults and other at-risk populations to have access to health care in the home setting. Home-based care is crucial to ensuring that this pandemic does not create devastating long-term health consequences due to delayed care. The highly skilled and compassionate care that home health agencies provide are an important component of this inhome care.

I have been a strong supporter of home care since my very first home visit, which took place in my hometown in Aroostook County early in my Senate service. This experience gave me the opportunity to meet and visit with home health patients, where I saw first-hand what a difference highly skilled and caring visiting nurses and other health care professionals make to the lives of patients and their families. I have been a passionate advocate for home care ever since.

In March, my bipartisan home health legislation, the Home Health Care Planning Improvement Act, became law as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This new law will improve the access Medicare beneficiaries have to home health care by allowing physician assistants, nurse practitioners, clinical nurse specialists, and certified nurse midwives to order home health services. Far too often seniors experience unnecessary delays in accessing home health care. To avoid these needless delays, it is common sense that other medical professionals who are familiar with a patient's case should be able to order these services.

Home health professionals have continued to provide face-to-face services during the COVID-19 public health emergency, but this crisis has created additional challenges, including the need to maintain an adequate supply of personal protective equipment to protect themselves, their patients, and their patients' families. The use of telehealth and virtual visits can help address these challenges. Unlike other Medicare providers, however, home health agencies are not eligible to receive Medicare reimbursement for telehealth services during the COVID-19 emergency.

In May, I led Congress' first hearing examining COVID-19's devastating impact on seniors. During the hearing, Dr. Steven H. Landers, President and CEO of the Visiting Nurse Association Health Group, testified that, despite this lack of Medicare reimbursement, his organization has found telehealth to be an essential part of providing high quality home health care during the COVID-19 public health emergency. He urged action to ensure that home health providers can continue offering these critical services remotely.

Maine home health care providers have also shared stories about how telehealth is helping them to continue caring for their patients during COVID-19. Through a combination of video visits and care calls, one provider has been able to care for a woman with severe heart and lung disease and keep this patient out of the hospital. The nurse would speak with the woman by phone a couple of times per week to assess any symptoms that needed follow up. If the nurse identified an issue during the call, she would schedule a video visit and also work with the patient's physician to modify medications as needed.

The bill I am introducing today would authorize Medicare reimbursement for home health services provided through telehealth during a public health emergency where telehealth can be used appropriately. The services would not be reimbursed unless the beneficiary consents to receiving the services via telehealth. To ensure that the Medicare home health benefit does not become a telehealth-only benefit, Medicare reimbursement would only be provided if the telehealth services constitute no more than half of the billable visits made during the 30-day payment period.

Home health serves a vital role in helping our nation's seniors avoid more costly hospital visits and nursing home stays. The COVID-19 emergency has further underscored the critical importance of home health services and highlighted how these agencies are able to use telehealth to provide skilled care to their patients. The Home Health Emergency Access to Telehealth (HEAT) Act would ensure that seniors in Maine and across the country retain access to remote home health services during the COVID-19 emergency and future public health emergencies.

Thank you, Mr. President.