Telehealth gets extension from Congress, but doctors lose out again

Lawmakers approved a federal spending package that meets some key healthcare priorities, and falls short on a key concern of doctors.

Congress approved a short-term extension for telehealth in its spending package, but lawmakers didn't reverse cuts in Medicare payments to doctors.

President Trump signed a short-term spending bill Saturday to avoid a government shutdown. The bill funds federal programs through September.

The spending package includes support for telehealth programs, but doesn’t block cuts in Medicaid payments to physicians.

Telehealth

The package provides an extension for telehealth programs, including hospital-at-home programs, through the end of September. Federal waivers for telehealth programs were set to expire at the end of March.

Telehealth advocates had hoped to secure a multi-year extension but also were seeking to ensure at least some provision to avoid an interruption in virtual care programs.

Kyle Zebley, senior vice president of public policy for the American Telemedicine Association, said the measure ensures millions of patients continue to have access to telehealth services.

“We have avoided a shutdown for telehealth services,” Zebley said in a statement. “This is a big victory for telehealth, and a huge relief for patients and clinicians in every state and region of the United States, especially those in underserved communities.”

While Congress and the Trump administration ensured that telehealth programs will continue, telehealth advocates find themselves in a familiar position. Because they only secured a short-term extension, healthcare groups will be facing another deadline for the expiration of telehealth programs in a matter of months.

Telehealth groups and leaders of hospital-at-home programs have said the uncertainty over the funding climate makes it difficult for long-term planning.

Zebley, the executive director of ATA Action, the telemedicine association’s policy arm, said, “the shortened duration of the extensions included are an impediment to long-term certainty.”

Telehealth advocates were disappointed last December when it appeared Congress was on the cusp of approving a two-year extension for most telehealth programs, and a five-year extension for hospital-at-home programs. But those provisions were eliminated in a short-term spending plan Congress finalized just before the holidays.

Payments to doctors

Doctors and medical groups had pressed Congress to prevent reductions in Medicare payments to physicians, but they received no relief in the spending package.

The Centers for Medicare & Medicaid Services had previously approved a 2.8% cut in payments to doctors for 2025, but physicians implored lawmakers to avert the cuts or at least soften the blow. But the continuing resolution didn’t address the cuts.

Anders Gilberg, senior vice president of the Medical Group Management Association, criticized lawmakers for their lack of action.

“The passage of the CR without a Medicare physician payment fix represents a massive congressional failure and blatant abdication of duty to our nation's physicians and their beneficiaries,” Gilberg said in a statement.

Doctors have seethed over cuts in Medicare reductions in payments in recent years. They say that the cuts are prompting some doctors to stop taking Medicare patients and some independent practices to close.

The MGMA has been pressing Congress to revamp Medicare’s payment formula for doctors, including mechanisms to account for inflation.

“To avoid this annual chaos, which increasingly threatens beneficiary access to care, Congress must realize permanent, sustainable solutions, such as implementing an annual, inflation-based physician payment update tied to the full Medicare Economic Index and modernizing Medicare's antiquated budget neutrality policies,” Gilberg said.

The American Medical Association has also pressed lawmakers to enact change in Medicare’s payments. The AMA hailed the Medicare Payment Advisory Commission for a recommendation last week to factor inflation in Medicare’s payments.

Bruce A. Scott, MD, president of the American Medical Association, said fundamental reforms are needed.

“Medicare is broken,” Scott said in a statement. “Under the financial stress, burnout has become an occupational hazard for physicians. As these cuts pile up year after year, more and more physicians are closing their practices, leaving patients without access. It just makes sense that payment must keep pace with increasing costs.”