Can kicked down road: telehealth flexibilities extended to 30 September

March 18, 2025 | by

The Friday-passed Continuing Resolution extended telehealth flexibilities once again. This CR extension of a ‘flat’ budget kicked the can once again by extending all existing telehealth provisions until the end of the Federal fiscal year, which is 30 September.

The parts extended are:

  • Medicare telehealth flexibilities for synchronous telehealth, enabling telehealth visits to occur from a wider range of locations, including the patient’s home, and permits additional qualified provider types to deliver virtual care. This includes RHCs and FQHCs (see below) (2207)
  • The Acute Hospital Care at Home Program that allows Medicare-certified hospitals to furnish inpatient-level care in patients’ homes. (2208)
  • The Special Diabetes Program, without expansion. (2102)

The CR also extended funding for community health centers  and teaching health centers that operate graduate medical education programs (2101). However the disparity in funding telehealth versus in-person for rural health clinics (RHCs) or federally qualified health centers (FQHCs) for telehealth, added under the CARES Act 2020, remains.

It does not include an expanded diabetes program, first dollar coverage for High Deductible Health Plan-Health Savings Accounts (HDHP-HSA), telehealth as an excepted benefit, and expanded and in-home cardiopulmonary rehabilitation services, previously covered in earlier budgets.

The challenge remains for the next fiscal year beginning 1 October, and to be debated this summer, to make these Federal telehealth expansions permanent. Telehealth user organizations, their providers, digital health developers, commercial health plans, and investors then can make long term projections based on permanence. That would provide much-needed stability to this part of the industry. ATA/ATA Action Release, Healthcare Brew, FierceHealthcare, 

There are three Congressional bills that make telehealth services permanent but again they separate telehealth into multiple parts and are not comprehensive. From the National Law Review today:

1. Telehealth Modernization Act of 2024 (H.R. 7623) This bill seeks to permanently extend certain telehealth flexibilities that were initially authorized during the COVID-19 public health emergency.

2. Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 (H.R. 4189; S. 2016) This bill proposes to expand coverage of telehealth services under Medicare, aiming to remove geographic restrictions and expand originating sites, including to allow patients to receive telehealth services in their homes.

3. Preserving Telehealth, Hospital, and Ambulance Access Act (H.R. 8261) This bill aims to extend key telehealth flexibilities through 2026, including provisions for hospital-at-home programs and ambulance services.

The debate around these services is separate from the debate around teleprescribing controlled substances, which are under the Drug Enforcement Administration (DEA) and Health and Human Services (HHS). These are debated in this week’s and last week’s Perspectives.

Breaking: Will telehealth extensions survive past 31 March? ATA addresses rumors.

February 21, 2025 | by

The answer is “we’re working on it”. As Readers recall from the blur that the final Federal budget extension turned out to be, cut down from an elephantine 1,547 pages to 118 pages, three telehealth provisions from the American Relief Act (ARA), of a total of six in the elephant version, were approved through 31 March [TTA 19 Dec]:

  • The Special Diabetes Program (Sec. 3102)
  • Telehealth flexibilities (Sec. 3207)
  • Hospital care at home (Sec. 3208)

A more extensive explanation of the above three that were extended, and the provisions that were omitted, is available here from law firm McDermott Will & Emery.

The American Telemedicine Association‘s advocacy arm, ATA Action, has sent out an email to media rebutting current rumors that the telehealth flexibilities will not be extended. They affirm that President Trump and his team are working with Congress to extend telehealth flexibilities. Since there is no link as of yet on ATA’s site, your Editor is doing what she never does, which is to print a release verbatim deleting only the ‘about’ section–because of its importance. The ATA release as PDF:

ATA ACTION ADDRESSES RUMORS REGARDING TELEHEALTH EXTENSIONS

 WASHINGTON, D.C., FEBRUARY 21, 2025 – ATA Action, the advocacy arm of the American Telemedicine Association, addressed today’s rumors, mistakenly claiming that telehealth services will not be extended past the March 31 deadline.

“Despite today’s rumors, our conversations on Capitol Hill confirm that President Trump and his team are actively working with Congress to extend vital telehealth flexibilities beyond the looming March 31, 2025, deadline,” said Kyle Zebley, senior vice president, public policy, the ATA and executive director, ATA Action. “Telehealth is a bipartisan success story, delivering affordable, safe, and effective care to millions of Medicare beneficiaries. In 2020, the Trump administration acted swiftly to expand telehealth access, a move that has since enjoyed broad support across Congress and the Biden administration. Telehealth must always remain a bipartisan issue.

“We commend both Administrations and Congress for their leadership and urge them to make telehealth flexibilities permanent or extend them for as long as possible. Medicare beneficiaries deserve access to care that is convenient, effective, and uninterrupted,” Zebley added. “Patients, providers, and policymakers across the aisle recognize its value, and ATA Action remains committed to preserving and strengthening this support. We stand ready to work with all lawmakers and the administration to keep telehealth accessible and ensure it remains a cornerstone of modern healthcare. We cannot afford to let access to telehealth expire on April 1.”

The next few weeks will tell, now that RFK, Jr. is now confirmed at HHS. And Congress will be pressed to address not only the budget, but also the scorching hot button of extending previous tax cuts to help jumpstart the economy.

Congress may extend emergency telehealth flexibilities for Medicare, high-deductible plans for five months in spending bill

March 10, 2022 | by

The quaintly titled 2,741 page $1.5 trillion omnibus bill to fund the US government for the remainder of fiscal 2022, rolled out in the wee hours of Wednesday, includes an extension of telehealth flexibilities established under the COVID-19 public health emergency (PHE). The flexibilities extend full geographic coverage (versus rural only), location (home and medical facilities), and full payment for beneficiaries and providers, including some audio-only visits. This will apply, however, only to Medicare beneficiaries and providers, members of high deductible health plans (HDHP), and patients of rural health clinics (RHCs), and Federally Qualified Health Clinics (FQHCs). This is a five-month stopgap into 14 September. (The Federal fiscal year 2023 starts 1 October.)

The telehealth rule extension includes:

  • Practitioners such as physical therapists, occupational therapists, special therapists, and audiologists 
  • Originating sites can be anywhere in the US including the home and medical facilities
  • 1,400 Federally Qualified Health Centers (FQHCs) and 4,300 Rural Health Clinics (RHCs) can continue providing telehealth services including mental health visits
  • Waiving in-person initial visit requirement for mental health as well as postponing the in-person visit six months after receiving a telehealth visit
  • Audio-only allowed for Medicare
  • HDHPs have a continued ‘safe harbor’ to offer members telehealth services pre-deductible for the remainder of the 2022 plan year 

The vote is scheduled for the House today (9 March–still not finalized as of this writing), and to the Senate 11 March, with a concurrent short-term funding extension to give the Senate the usual time through 15 March. As of this time of writing, the floor wrangling continues with COVID-19 funding dropped and $13.6 billion in emergency non-defense aid to Ukraine added. The inclusion was cheered by ATA and ATA Action in their release; also Becker’s Hospital Review and Roll Call.  Update: the House passed the domestic portion of the bill 260-171 late Wednesday 9 March evening, and it moves on to the Senate.