Telehealth Coverage Flexibilities Reinstated as Government Shutdown Ends
Flexibilities for Medicare telehealth coverage are back in place after Congress passed legislation to end the longest government shutdown in U.S. history this week. The stopgap funding law, signed by President Donald Trump late Wednesday, reinstates pandemic-era virtual care policies through Jan. 30. These policies include changes like eliminating geographic restrictions for virtual care and allowing all eligible Medicare providers to offer telehealth.
In addition, the spending plan reauthorizes the CMS’ Acute Hospital Care at Home program through Jan. 30. This initiative permits hundreds of hospitals across the country to provide inpatient level care in patients’ homes.
The spending law comes after telehealth providers were left in limbo for six weeks during the government shutdown, unsure about reimbursement for virtual care services. While the legislation allows retroactive payment for telehealth services offered since the shutdown began in October, there is a time limit before the flexibilities could expire again.
Telehealth groups have emphasized the need for certainty in virtual care coverage in Medicare, urging for a long-term solution rather than short-term extensions. The popularity of telehealth flexibilities has been evident on both sides of the aisle, with lawmakers recognizing the importance of preserving access to care through telehealth.
The telehealth flexibilities were initially put in place during the pandemic to ensure access to care amid social distancing measures. These policies greatly expanded telehealth in Medicare, where coverage was previously limited to certain beneficiaries in rural areas or for specific facilities or services.
Despite the popularity of these flexibilities, they have faced challenges in funding fights between Democrats and Republicans. Previous attempts to extend the flexibilities for longer periods of time have fallen through, resulting in short-term deals that have caused disruptions in telehealth services for Medicare beneficiaries.
The recent lapse in telehealth flexibilities resulted in a decline in virtual care visits for Medicare beneficiaries, impacting states like Florida, Washington, Maryland, and New York. Clinicians were uncertain about reimbursement for virtual care visits during the shutdown, leading to cancellations of telehealth appointments.
Providers and telehealth advocates have emphasized the need for making these flexibilities permanent to ensure continued access to telehealth services for patients. The uncertainty and roller coaster of short-term extensions have been disruptive for both providers and patients, highlighting the importance of a long-term solution for telehealth coverage in Medicare.
Moving forward, it is crucial for the federal government to address the need for permanent telehealth flexibilities to ensure continued access to care through virtual means. Patients, providers, and advocates alike are calling for a more stable and sustainable approach to telehealth coverage in Medicare.
