Workforce/Behavioral Health/Telehealth

State of Play:  During the pandemic crisis, the Centers for Medicare and Medicaid Services (CMS) has asked for additional input and recommendations for eliminating specific Medicare regulations that require more stringent supervision of non-physician providers than existing state scope of practice laws.  CMS will temporarily pay clinicians to provide telehealth services for Medicare beneficiaries during the “National Emergency Concerning the Coronavirus (COVID-19).”  CMS has agreed to reimburse providers for providing coverage across state lines through individual state 1135 waivers to address states’ needs for more providers to help treat patients affected by COVID-19. 

HLC Position:  HLC believes health system stability includes having a well-trained workforce to meet the needs of our country’s evolving health system, as well as our growing and aging population.  This must include an emphasis on rural health.  HLC also supports the expanded use of telemedicine and immigration rules that allow recruitment of nurses and other workers critical to the healthcare industry.  Improved policies and payment methodologies in telemedicine services will further help meet patient needs.  Nonphysician providers should be allowed to practice to the full scope of their training and should be reimbursed for such services.  More must be done to make mental and behavioral health services more accessible and integrated for those who can benefit from them. 

HLC Recent Activity:

  • On April 2, HLC conducted a call with Senate Judiciary minority staff to discuss the need for additional regulatory waivers during the COVID-19 response.
  • On March 25, HLC issued a press release praising the Department of Health and Human Services’ (HHS) efforts to extend the capacity of the healthcare workforce and create flexibility to address workforce needs in areas hardest hit by the COVID-19 pandemic.
  • HLC has worked with HHS to get letters to governors on waiving state licensure requirements for healthcare providers amid the COVID-19 pandemic.
  • On March 20, HLC signed a letter to Senate leadership expressing support for S. 3539, which would exempt telehealth services from certain high-deductible health plan rules.
  • On March 18, HLC advocated to Vice President Mike Pence and House and Senate leadership via a coalition letter for expanding provider license capability and provider capacity to practice.
  • On March 11, HLC signed a joint letter to House and Senate leadership on strengthening telehealth for COVID-19.
  • On January 17, HLC submitted comments to CMS on efforts to eliminate regulatory requirements that restrict scope of practice in the Medicare program.
  • On December 4, HLC joined a group letter organized by the Association of American Medical Colleges to Senators Maggie Hassan (D/NH) and Susan Collins (R/ME) in support of S. 2892, the “Opioid Workforce Act.”
  • On November 13, HLC wrote the House Small Budget Committee in advance of its hearing on “Upskilling the Medical Workforce: Opportunities in Health Innovation.”
  • On October 3, HLC responded to the Health Resources and Services Administration’s (HRSA) Rural Access to Health Care Services request for information, advocating for vital workforce programs.
  • On September 7, HLC wrote the Bipartisan Policy Center’s Rural Health Task Force, supporting valuable workforce programs such as teaching health center graduate medical education and National Health Service Corps.
  • On June 26, HLC wrote the House Ways and Means Committee (W&M) in advance of its health markup, which included consideration of H.R. 3414, the “Opioid Workforce Act.”
  • On June 26, HLC joined a group letter with the Association of American Medical Colleges in support of H.R. 3414, the “Opioid Workforce Act.”
  • On February 28, HLC wrote the Senate Health, Education, Labor, and Pensions (HELP) Committee on the importance of workforce programs that train providers to care for rural residents.
  • As part of HLC’s High-Need Beneficiary Playbook, several recommendations focus on workforce needs. These include payment to support better care coordination and an adequate workforce of physicians, community health workers, and other direct health professionals, as well as adoption of the nurse licensure compact in all 50 states.