Since the beginning of the COVID-19 pandemic in 2020, over 96 million people living in the United States have been infected and over one million have lost their lives to the disease. In an effort to shield older adults and people with disabilities from needless exposure to COVID and potentially reduce the spread, the Centers for Medicare & Medicaid Services (CMS) employed waivers and flexibilities around the use of telehealth services. It resulted in an approximate 6,000% increase in the use of telehealth by Medicare beneficiaries from 2019 to 2020.
As lawmakers and policymakers examine which telehealth flexibilities should be made permanent after the end of the public health emergency, the Government Accountability Office (GAO) has recently published a report cautioning the need for increased oversight by CMS and education support by the Health and Human Services (HHS) Office of Civil Rights (OCR).
The three specific GAO recommendations for CMS are:
- For the agency to develop an additional billing modifier or clarify its guidance regarding billing of audio-only office visits to allow the agency to fully track these visits.
- For CMS to require providers to use available site of service codes to indicate when Medicare telehealth services are delivered to beneficiaries in their homes.
- For the agency to comprehensively assess the quality of Medicare services, including audio-only services, delivered using telehealth during the public health emergency.
The GAO also recommended that OCR provide additional education and assistance to providers to help them explain the privacy and security risks to patients when using video telehealth platforms in layman’s terms.
The agency reached these recommendations by examining Medicare claims data from 2019 through 2020, along with reviewing federal statutes, CMS documents, and OCR guidance, along with interviewing agency officials.
October 13, 2022 – C. St. John
 CDC. COVID Data Tracker. (Updated Oct. 4, 2022). Available at: https://covid.cdc.gov/covid-data-tracker/#datatracker-home
 U.S. GAO. Medicare Telehealth: Actions Needed to Strengthen Oversight and Help Providers Educate Patients on Privacy and Security Risks. (Sept. 29, 2022). Available at: https://www.gao.gov/products/gao-22-104454