Payer & Policy Advocacy

The rapid growth of telehealth seen in 2020 would not have been possible were it not for the temporary expansion of telehealth reimbursement coverage afforded during the COVID-19 Public Health Emergency. If telehealth is to remain a mainstream, critical part of delivering efficient and effective care in South Carolina, then these temporary flexibilities must be made permanent.

In 2020, SCTA partners published a position statement outlining key policy requirements needed to sustain telehealth into the future.

  • Cover telehealth services. Health insurers should be required to provide coverage for health care services delivered via telehealth to the same extent the services would be covered if delivered via an in-person encounter.

  • Remove originating site restrictions. The COVID-19 pandemic has clearly demonstrated the need for telehealth in rural areas, in urban areas, at work, at school, at home, and many other locations. Originating site restrictions are obsolete and outdated; the location of the patient should not matter for telehealth.

  • Remove provider type restrictions. Health insurers should cover the full range of providers that make up the care team and that can deliver telehealth-appropriate services.

  • Provide equitable payment for services delivered via telehealth. Reimbursing telehealth visits at rates considerably less than in-person care disincentivizes providers and health systems from utilizing telehealth.

  • Address systemic barriers preventing vulnerable populations from accessing telehealth services. Barriers include lack of internet connectivity for those in rural or low-income communities and costs associated with audio-visual devices and connected health monitoring equipment.

South Carolina has come too far with telehealth this past year to go back. In the year ahead, the SCTA will be working with its health care, payer, and legislative partners to ensure the important gains made in telehealth coverage are not lost.