Shaheen & McSally Call on TRICARE to Cover Full Scope of Telehealth Services Amid COVID-19 Crisis, Ensure Access to Mental Health for Service Members & their Families

May 05, 2020

Medicare & Medicaid Lifted Restrictions on Coverage for Telehealth Services Due to the COVID-19 Crisis, Senators Shaheen & McSally Now Lead a Bipartisan Call for TRICARE to Follow Suit 

Last Month, Heeding Shaheen’s Bipartisan Call, CMS Changed Guidelines to Cover Telephone-Based Telehealth Services in the Same Way as Video Telehealth Amid COVID-19 Pandemic 

(Washington, DC) – U.S. Senators Jeanne Shaheen (D-NH) and Martha McSally (R-AZ) sent a letter yesterday to the Defense Health Agency (DHA) calling for it to cover the full scope of telehealth services under TRICARE amid the COVID-19 crisis, particularly mental health care. Medicare and Medicaid have lifted restrictions due to the public health emergency and the Senators are calling on DHA to do the same for TRICARE. New Hampshire medical centers that provide mental health services have reported difficulty billing TRICARE for telehealth appointments.

The Senators highlighted the critical role of telehealth services amid the COVID-19 pandemic to ensure service members and their families can continue with necessary medical appointments, particularly mental health services. However, providers have reported that reimbursements for certain telehealth services are not being upheld by TRICARE. In their letter, the Senators cited updated guidelines from the Centers from Medicare and Medicaid Services (CMS) to allow greater flexibility in Medicare coverage for telehealth services to help ensure those who need medical assistance do not experience cost as a barrier to care.

Shaheen and McSally wrote, “…the Centers for Medicare and Medicaid Services (CMS) has significantly expanded Medicare coverage of services now offered through telehealth, including mental health visits. Unfortunately, we have heard concerns that TRICARE has not made the same level of commitment to telehealth flexibilities for mental health services, as compared to the Medicare program and private insurers. This could force military members and their families battling mental illness to risk their own physical health and potential COVID-19 infection in order to access the mental health treatment they need.”

The Senators closed their letter by urging DHA to take action and allow for similar flexibility as currently exists in Medicare for services provided through telehealth to TRICARE beneficiaries, consistent with CDC recommendations. They concluded their letter, “Service members undertake an incredible sacrifice to protect our country, and it is all too often that the strains of a military deployment take a toll on the mental health of themselves and their families. It is critical that they continue to receive mental health services at all levels of care without risking exposure to COVID-19.”

Full text of the letter is available here.

Last month, the Centers for Medicare and Medicaid Services’ heeded Shaheen’s bipartisan call and updated guidelines to bring Medicare reimbursement for telephone-based health services in line with Medicare reimbursement for video telehealth. Telephone-based telehealth is vital for New Hampshire’s rural communities that do not have reliable broadband services to facilitate video telehealth.

Senators Shaheen and McSally have a history of working together to improve TRICARE coverage for service members and veterans. In January, in response to a bipartisan call from the Senators and following the introduction of their bipartisan legislation to address the issue, the Department of Defense agreed to expand TRICARE coverage to include 3D mammography – the most effective breast cancer screening option.