Another Reprieve? Proposed Budget Bill Includes Telehealth, HaH Extensions

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By Eric Wicklund

The up-and-down battle over Medicare telehealth and Hospital at Home waivers is on the upswing again, as a proposed bill to fund the government through September includes extensions for both.

But in typical good news-bad news fashion, those proposed extensions would only run to September, leaving health systems and hospitals wondering whether to keep those programs going or shut them down.

According to the American Telemedicine Association (ATA) and several others, the proposed Continuing Resolution unveiled on March 8 keeps in place pandemic-era waivers on key telehealth coverage and the Centers for Medicare & Medicaid Services’ (CMS) Acute Hospital Care at Home (AHCAH) program through September 30. Advocates say this would give Congress more time to negotiate a long-term deal, such as a five-year extension supported by the ATA and others.

“We appreciate Congress taking action to prevent a lapse in these vital telehealth flexibilities,” Kyle Zebley, Executive Director of ATA Action, the ATA’s lobbying arm, said in a press release. “While we would have preferred a longer extension, this step ensures uninterrupted access to telehealth services for patients and clinicians, as we continue working toward permanent solutions that reflect the needs of modern healthcare.”

As with the stopgap funding bill passed by Congress last December, the new proposed bill would extend to September 30 the following telehealth flexibilities:

  • Waiving geographic restrictions on telehealth coverage and use;
  • Expanding the list of providers able to bill Medicare for telehealth services;
  • Allowing audio-only telehealth services;
  • Easing originating site restrictions on telehealth so that the patient can receive treatment at home;
  • Waiving the in-person requirement for telemental health treatment;
  • Enabling telehealth service for hospice care; and
  • Enabling Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to use telehealth.

In addition, the bill would extend the CMS waiver for its AHCAH program, enabling the more than 350 health systems following the CMS model to receive Medicare reimbursement.

And like the December bill, several telehealth flexibilities supported by the advocates didn’t make the cut. They include:

  • First dollar coverage of High Deductible Health Plans (HDHPs) and Health Savings Accounts (HSAs);
  • Support for virtual care providers in the Medicare Diabetes Prevention Program;
  • Improved coverage for digital health in home-based cardiology and pulmonary rehab programs; and
  • The SPEAK Act (HR 6033), which paves the way for accessible telehealth services.

The ATA’s Zebley said the inclusion of the telehealth and Hospital at Home extensions indicate that Congress “has listened” to the intense lobbying effort by the organization and others. But he also acknowledged that “the path forward remains uncertain.” There’s no guarantee that Congress will approve a final bill that includes those provisions.