[Congressional Record Volume 166, Number 182 (Friday, October 23, 2020)]
[Senate]
[Pages S6415-S6416]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTION

      By Ms. COLLINS (for herself and Mr. Cardin):
  S. 4854. A bill to provide payments for home health services 
furnished via visual or audio telecommunication systems during an 
emergency period; to the Committee on Finance.
  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

[[Page S6416]]

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.

                          ____________________