OIG Urges CMS to Evaluate Home Health use of Telehealth

By: Diane Eastabrook

McKnights Home Care

October 20, 2022

The Office of Inspector General (OIG) urged the Centers for Medicare & Medicaid Services to evaluate how the use of telehealth affected the quality of home healthcare during the COVID-19 pandemic. The government watchdog issued the recommendation in a report to the Department of Health and Human Services on Tuesday.

The OIG surveyed 400 home health agencies in the fall of 2021 about their experiences during the pandemic, because it said HHAs “play an important role in caring for Medicare beneficiaries.” Due to staffing and infection control issues over the past 30 months, home health agencies were granted flexibilities to help mitigate those difficulties. However, the OIG found staffing problems persist, along with home health’s use of telehealth, raising questions about how it should be utilized in the future.

Among the challenges HHAs faced with telehealth during the pandemic were access to phone service, internet, and equipment; assessing patients with the remote technology; and lack of reimbursement. Rural agencies had an every harder time with telehealth, with most pointing to insufficient internet as an obstacle, the OIG said. Among all the agencies that used telehealth during the pandemic, 43% anticipated they will not use it afterwards; 57%, however, said they would, according to the OIG. The report noted that CMS lacks insight into HHAs’ use of telehealth due to limited reporting requirements.

The government watchdog also said emergency preparedness plans required by CMS guided HHAs’ responses to the pandemic but “fell short of fully addressing a global emergency such as COVID-19.” As a result, the agency is recommending CMS collaborate with the Administration for Strategic Preparedness Response Technical Resources Assistance Center to apply what it learned during the PHE to update or develop emergency preparedness training for HHAs on future infectious disease outbreaks. CMS has agreed with the recommendations.

At the beginning of the pandemic, HHS issued a number of waivers and new rules to help home health agencies during the PHE. In addition to granting flexibility through the use of telemedicine, the department also gave HHAs additional time to submit patient assessments. Earlier this month, the Biden administration extended the COVID-19 PHE through Jan. 11, 2023.

Last summer, the House passed legislation that would extend telehealth benefits and reimbursements through 2024. The bill is now before the Senate.

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