Telehealth Visits Skyrocket; Some Insurers Refuse Coverage

By Diane Bernard, Public News Service-WV

December 30, 2020

CHARLESTON, W.Va. -- Telehealth visits have jumped nationwide since the onset of the pandemic. Between mid-March and mid-June, an estimated 9 million people on Medicare relied on telemedicine.

Among private insurers, data show, telehealth visit claims have increased by more than 4,000%. But now, some insurance companies are pulling back from covering non-COVID-related virtual visits, and costs for patients increasingly are muddled. Some could even end up with surprise medical bills, said Tom Conroy, chief executive of the health-care technology company MedSign.

"They do not have safeguards. There's no safeguard in the system where they can actually tell if a telehealth session occurred officially," he said. "Last year in Florida, there were fraudulent charges for telehealth to the order of $1.2 billion. And the reason is, there's no controls in the system."

However, denying access to telehealth coverage could have major repercussions for rural states such as West Virginia, where transportation continues to be a barrier for patients seeking care and where hospitals and providers have relied on telehealth payments to stay afloat during the pandemic.

In the long run, Conroy said, covering telehealth visits could save the government Medicare dollars by encouraging preventive care.

"Seniors use 75% to 80% of all Medicare dollars," he said. "One of the reasons why is, they go into the hospital. The minute they step over the emergency-room doorway there, it's $3,000. If they stay inside of a hospital, either in New York or California -- in Los Angeles, it's $17,000 a day. Extraordinary costs."

The American Medical Association and several lawmakers have voiced support for the Telehealth Modernization Act, legislation that would increase access to telemedicine from all types of providers, and ensure Medicare coverage for virtual visits.

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