With recent stopgap legislation, Congress once again extended Medicare Telehealth Flexibilities, from March 31 through the end of September. However, the shortened duration of this latest extension is a red flag, say some healthcare organizations.
WHY IT MATTERS
The FY2025 Continuing Resolution passed earlier this month prevented a federal government shutdown and offered telehealth extensions for Medicare patients for another six months.
“We have avoided a shutdown for telehealth services,” Kyle Zebley, executive director of the American Telemedicine Association and ATA Action, said in a statement March 15. “This is a big victory for telehealth, and a huge relief for patients and clinicians in every state and region of the United States, especially those in underserved communities.”
Congress also granted permission for telehealth visits to occur from a wider range of locations – including the patient’s home, ATA said in a statement. Additional qualified provider types may also deliver virtual care.
“By including these provisions in this stopgap legislation, Congress sent a very clear message that telehealth is a fundamental part of care delivery and that we must not reverse the significant progress made in modernizing our healthcare system,” Zebley added.
Previous extensions to telehealth flexibilities pushed expirations for one-year durations, however, which prompted notes of concern among the sentiments of support from the healthcare sector.
“HIMSS strongly supports Congress’ inclusion of a short-term extension for telehealth services in the FY2025 Continuing Resolution, keeping vital access to care capabilities available to millions of Medicare patients,” a spokesperson from the organization’s government relations team said Wednesday.
“However, more action is needed to extend the program beyond this fiscal year. We will continue pushing for a sustainable and long-term solution, and we look forward to working with Congress to make telehealth access permanent for all Medicare beneficiaries,” according to HIMSS, parent company of Healthcare IT News.
ATA said it also found the new six-month “telehealth cliff” concerning, along with the number of telehealth programs that expired or are absent from the resolution.
“The shortened duration of the extensions included are an impediment to long-term certainty, and the exclusion of other essential telehealth programs that expired or were absent from the final bill continues to prevent millions of individuals from accessing needed care,” Zebley said.
ATA said Wednesday that Zebley was referring to three specific programs.
The First-dollar coverage of High Deductible Health Plans-HSAs program, which expired in December, could result in 32 million Americans paying out-of-pocket for telehealth services, which is “unaffordable for many.”
Also, the 2023 expirations of telehealth benefits for part-time or contracted employees and in-home cardiopulmonary rehabilitation services for hundreds of thousands of patients have not been addressed by lawmakers.
“We must fix this, for the sake of patients, clinicians and our ailing healthcare system,” said Zebley.
At press time, the official U.S. Department of Health and Human Services’ telehealth policy update page has not reflected the new legislative changes.
The FY25 stopgap legislation passed by Congress also extended the Acute Hospital Care at Home Program through September, allowing Medicare-certified hospitals to provide inpatient-level care at patient homes.
In October, the U.S. Centers for Medicare and Medicaid released a study that showed lower Medicare spending overall – as well as lower mortality rates – when compared to brick-and-mortar inpatient care.
THE LARGER TREND
Telehealth has become vital to Medicare, particularly where patients use virtual care for behavioral health services. Thus, Congress made Medicare coverage of remote behavioral health permanent in December 2020.
Lawmakers have since kicked the can down the road on other telehealth benefits.
A two-year extension for the telehealth Medicare benefit proposed in December, or a permanent extension that could cost $25 billion over 10 years by Congressional Budget Office estimates, looked unlikely leading up to the vote on the spending bill, according to a March 17 report in Kaiser Family Foundation Health News.
“President Trump and Elon Musk blew up the continuing resolution last December that would have extended these telehealth authorities by two years,” said Democratic Rep. Ro Khanna, D-California, in an email obtained by KFF.
The CBO’s expanded telehealth coverage costs were reportedly based on a figure of $663 million for five months of extended coverage and anticipation of level spending through fiscal year 2031.
“Trump should work with Congress to extend telehealth coverage for Medicare beneficiaries,” Khanna said in the story.
ON THE RECORD
“We are also encouraged by Dr. Mehmet Oz’s comments [March 14] at his Senate confirmation hearing. As President Trump’s nominee to lead the Centers for Medicare and Medicaid Services, he emphasized telehealth as ‘a major focus’ and confirmed ‘it’s one of the areas I think we’ll be able to make major inroads because there are no opponents to this,'” Zebley noted in a statement.
“This clearly indicates the administration views telehealth as vital to our healthcare system.”
Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.