Medicare telehealth flexibilities and the Acute Hospital Care at Home (AHCaH) program are teed up to receive multi-year extensions from Congress in its recently released funding package for the Department of Health and Human Services.
The extensions would provide more certainty for the industry than it’s had since the end of 2022, when Congress extended Medicare telehealth and hospital-at-home for two years. Since the end of 2024—and President Donald Trump’s election—providers and hospitals have faced a series of months-long virtual care extensions as Congress struggled to find a bipartisan solution to fund the government.
On Tuesday, the House appropriations committee unveiled a funding package that includes a slew of healthcare reforms as well as funds HHS through the 2026 fiscal year.
The Medicare telehealth waivers get a two-year extension in the bill – through Dec. 31, 2027 – allowing providers and patients to continue virtual visits as they have since the beginning of the COVID-19 pandemic.
The telehealth provisions in the bill include removing Medicare’s geographic requirements for telehealth and expanding the types of practitioners able to furnish telehealth services for the government health program.
If passed, the bill would also allow federally qualified health centers (FQHCs) and rural health clinics (RHCs) to continue furnishing telehealth services, including mental health visits. The bill would continue to delay the in-person visit requirement for all mental health visits until on or after Jan. 1, 2028.
Providers can also provide healthcare services through audio-only formats, in cases when they deem it appropriate and necessary for the patient. The format is often used when patients lack a strong broadband signal for video visits.
Included in the proposed extension is a mandate for HHS to write guidance for providing telehealth to people with limited English proficiency and adding modifiers to telehealth billing codes furnished by virtual-only telehealth companies.
The House may vote on the package later this week, while a Senate vote won’t come until the following week. The upper chamber is in recess until Jan. 26, and government funding runs out four days later on Jan. 30.
Though the package was released by Republican appropriators, Democrats have thus far shown support for the proposal, including Rep. Rosa DeLauro, from Connecticut, the committee’s ranking member, and Sen. Ron Wyden, from Oregon, the top Democrat on the Senate Finance committee.
“We’ve seen before that even strong, bipartisan proposals can face unexpected hurdles late in the process, which is why it’s important not to take any outcome for granted when it comes to Congressional legislation,” Alexis Apple, deputy executive director, ATA Action and vice president of federal affairs at the American Telemedicine Association (ATA), said in a statement. “This momentum is real and meaningful, and it is a very good sign that telehealth provisions continue to advance with bipartisan support. We are optimistic this legislation can move forward, as it includes a number of strong bipartisan priorities and is not tied to the more partisan homeland security funding debate currently underway.”
The hospital-at-home program would receive a five-year extension if the bill clears Congress and the White House. The program would be authorized through Sept. 30, 2030, just shy of five years.
About 419 hospitals participate in the program and provide acute, hospital-level care to Medicare patients in their homes. The program was significantly disrupted during the 43-day government shutdown that began on Oct. 1.
The House of Representatives passed legislation in December that would extend the hospital-at-home waiver authority by five years and separate it from the ongoing government funding debates, which face bigger political hurdles.
The bill would include $116.6 billion in discretionary funding for HHS and reduces spending on “federal bureaucracy” at the agency by $100 million, according to a fact sheet (PDF) from the committee.
It also includes key hospital funding priorities, such as the Medicare-dependent hospital program and the increased inpatient hospital payment adjustment for some low-volume hospitals.
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