Medicare telehealth waiver extended again
Telehealth just had a pretty close call.
For those relying on Medicare, the expiration deadline for the telehealth waiver was set for March 31. The waiver was originally instituted in March 2020 because of the COVID-19 pandemic and its resulting global lockdowns.
As it had done in the past, Congress on March 14 extended the waiver until September as part of its spending bill.
Shortly after, the American Telemedicine Association (ATA) released a statement detailing what this legislation means.
• It extends Medicare telehealth flexibilities, enabling telehealth visits to occur from a wider range of locations, including the patient’s home;
• It permits additional qualified provider types to deliver virtual care; and
• The Acute Hospital Care at Home Program was also extended through September, allowing Medicare-certified hospitals to furnish inpatient-level care in patients’ homes.
“Congress has prevented millions of Americans from being cut off from essential healthcare services, ensuring that our seniors, children, and families can continue to access telehealth for another six months,” noted Kyle Zebley, senior vice president of the American Telemedicine Association (ATA).
Also the executive director of ATA Action, the activist arm of the organization, Zebley called avoiding a shutdown for telehealth, “a big victory and a huge relief” for patients and clinicians across the U.S., including in underserved communities.
While there are other provisions in the stopgap legislation Congress passed, Zebley said the ATA remains vigilant in its efforts to secure telehealth as a reliable method of healthcare.
“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 said.
Had the extension not passed, Medicare policies would default to pre-COVID standards.
The expiration date only applied to Medicare reimbursement. If Medicare was not the insurer, telehealth restrictions would not apply.
Medicare would cover telehealth for patients who live in rural areas or in regions without access to providers. It also covers telehealth for mental health services in rural, suburban, and urban areas but providers are required to see patients within six months of the initial telehealth visit and every 12 months following that.
The exceptions to these restrictions include any risks that outweigh the benefits of in-person patient visits, substance use disorder treatment with co-existing mental health issues, end-stage renal disease treatment, and acute stroke care.
While there has been bipartisan support in Congress to continue telehealth coverage, Republican-led initiatives have been more recently focused on cutting spending that would have directly affected Medicare and Medicaid.
The waiver technically ended when the pandemic was declared over in May 2023. But Congress continued to “kick the can” at certain points by folding in resolutions for telehealth into spending bills. This past December when telehealth restrictions were again set to expire, Congress granted an extension through a continuing resolution until March 31.
Prior to the decision, Zebley spoke to New England Psychologist about what would happen if Congress let the waiver expire. He predicted any expiration would not last long.
“There will be holy hell raised across the country. This will affect every state and constituents will let their voices be heard,” he said.
Calling telehealth “a rare example of bipartisan agreement,” Zebley predicted Congress would “take the path of least resistance…make a change in the 11th hour and just kick the can down the road.”