ACOG Urges Health Plans to Improve Telehealth Coverage and Provide Financial Support to Obstetrician-Gynecologists

This week ACOG sent letters to the nation’s largest health insurers and Medicaid managed care plans urging them to maintain telehealth coverage improvements put in place due to COVID-19 and provide direct financial support to their contracted obstetrician-gynecologists. 

Several major insurance companies expanded telehealth coverage, waived cost sharing for their enrollees, suspended prior authorization requirements, and implemented telehealth payment parity due to the COVID-19 pandemic. However, many of these insurers are set to suspend these policy changes in the coming weeks. ACOG has heard from our members that there is confusion regarding when expanded telehealth coverage policies will expire, so we wrote to all of the major insurers urging them to maintain their COVID-19 telehealth coverage and payment policies for the duration of the national public health emergency. This would reduce the administration burden and confusion caused by varying policies and expiration dates.

ACOG has also heard from our members that expanded access to evidence-based telehealth services has had a positive impact on both your practice and your patients. As a result, we are beginning a significant advocacy campaign to improve access to covered telehealth services across payers. We began by urging the major health insurance companies to expand the telehealth benefits they make available to their enrollees after the pandemic subsides. ACOG recommended that future benefit packages and covered Medicaid services include audio-video and audio-only visits with in-network providers, remote patient monitoring services for pregnant and postpartum women, and preventive care services via telehealth. We also urged these insurers to pay for these services at the same rate as in-person services. We will continue to keep you informed of these telehealth advocacy efforts, including opportunities for your voice to be heard. 

In addition, we wrote to the nation’s largest Medicaid managed care organizations (MCOs) urging them to take advantage of a new opportunity provided by the Centers for Medicare and Medicaid Services (CMS) for them to provide direct financial relief to obstetrician-gynecologists. Under the CMS guidance, MCOs are encouraged to utilize state-directed payments to temporarily enhance payments to physicians and other health care professionals under managed care contracts. Our letter urges MCOs to take advantage of these enhanced flexibilities and to prioritize obstetrician-gynecologists in any advanced payment efforts. We believe this opportunity is critical to maintaining access to essential health services provided by obstetrician-gynecologists – including prenatal care, preventive services, and cancer care – during and beyond the COVID-19 pandemic.

ACOG is continuing our other advocacy efforts to secure financial support for obstetrics and gynecology practices. Read more about our efforts. More than 330 ACOG members also joined with us to urge the Department of Health and Human Services to immediately direct relief funds to obstetrician-gynecologists. Visit our website to read more about telehealth policy changes and additional financial support resources.