Telehealth extensions have support in Congress, but spending deal collapses

Just two weeks before telehealth waivers are set to expire, Congress has shown support for an extension of virtual care programs.

Lawmakers have included language extending telehealth programs in a broader federal spending package. But the legislation still must be passed by Congress and signed by President Biden.

Congress is working on a broad federal spending package to fund government programs into March, and telehealth advocates said a spending plan included measures to extend telehealth programs.

The package included a two-year extension for most telehealth programs, and a five-year extension for hospital-at-home programs, according to the American Telemedicine Association.

Congress approved broad extensions of telehealth programs early in the telehealth pandemic, but those waivers were set to expire Dec. 31.

Telehealth advocates and a broad array of healthcare providers have been pressing Congress and President Biden’s administration to approve an extension of telehealth programs. They’ve been increasingly anxious as the end-of-year deadline has approached.

Lawmakers have also been grappling with another pressing deadline, as government agencies will shut down Friday night without new spending legislation.

Now, uncertainty looms with the collapse of a deal on the overall spending bill. Republicans aren't supporting the temporary spending bill after President-elect Donald Trump and Elon Musk denounced the deal, as The Washington Post reports.

Kyle Zebley, the senior vice president of the American Telemedicine Association, has called this the “Telehealth Super Bowl,” and he’s hoping for a win, even as the contest moves late into the fourth quarter.

“The extensions in this proposed legislation are very meaningful for countless Americans and would give our healthcare providers and hospital systems some certainty and the confidence needed to continue to invest in needed telehealth services,” Zebley said in a statement.

“This has been years in the making, and we must ensure that these extensions are kept intact as they go to vote in both chambers of Congress and then on to President Biden for signature.”

The measure included language to enable health systems to provide cardiopulmonary rehabilitation services via telehealth to Medicare beneficiaries in their home in 2025 and 2026. The package also included a five-year extension of the Medicare Diabetes Prevention Program Expanded Model through 2030, allowing services to be delivered virtually.

Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association, said the group is “pleased that Congress heeded our call to extend telehealth flexibilities through the end of 2026.” But the group said it’s frustrated that Congress hasn’t averted planned Medicare payment cuts to physicians.

Healthcare providers and trade groups have long expressed optimism that Congress and the Biden administration would ultimately sign off on an extension of telehealth programs. The House & Energy Commerce Committee passed the Telehealth Modernization Act unanimously with a 41-0 vote in September.

Republicans and Democrats in Congress have both expressed strong support for telehealth programs. But healthcare advocacy groups expected that Congress would likely deal with telehealth extensions in end-of-year spending bills, particularly with lawmakers spending so much time on the election in the fall. With the end of the year drawing closer, telehealth supporters have been sweating a bit.

Zebley is hopeful that providers won’t have to worry about virtual care programs being disrupted.

“This is shaping up to be a historic week for advancing telehealth and puts us on a path towards a modernized healthcare system,” Zebley said in a statement.

Health systems have expressed cautious optimism about a five-year extension of hospital-at-home programs. Nationwide, 378 hospitals in 39 states are providing acute care at home, according to data from the Centers for Medicare & Medicaid Services.

More providers are offering hospital-at-home programs, but some have been wary of launching such services until they get more certainty about the prospect of long-term reimbursements.

Last month, the federal government approved an extension for providers to continue remote prescriptions of certain controlled substances, such as Oxycontin and Xanax, through 2025.