Dive Brief:
Telehealth advocates and providers are urging Congress to let Medicare permanently pay for telehealth services as the longest government shutdown in U.S. history stretches into its second month.
The most recent short-term extension of telehealth flexibilities expired at the end of September after Congress failed to reach a consensus to fund the government. Virtual care access and reimbursement has been disrupted since. Now, more than 450 groups are pushing lawmakers to avoid a temporary fix in their next legislative package in a letter sent to House and Senate leadership on Tuesday.
The letter comes amid another looming telehealth deadline: Flexibilities that allow for remote prescriptions of controlled substances are set to lapse at the end of 2025.
Dive Insight:
Medicare telehealth flexibilities were first adopted during the coronavirus pandemic to preserve access to care as clinicians tried to limit in-person contact with patients.
The changes include policies like eliminating geographic restrictions for virtual care and allowing all eligible Medicare providers to offer telehealth. Before the public health emergency, coverage of telehealth in Medicare was largely restricted to beneficiaries living in rural areas, or for certain types of facilities or services.
Though the policies are broadly popular with lawmakers on both sides of the aisle, the flexibilities have frequently come close to expiration over the past year. In December, Congress only preserved the policies through March after a bill that contained a longer extension fell apart at the last minute.
An additional short-term extension kept the flexibilities in place for another six months through September. However, this fall lawmakers reached an impasse over a funding bill, allowing the government to shut down and the telehealth policies to lapse.
That’s created significant uncertainty for providers, who’ve had to curtail their telehealth offerings for Medicare beneficiaries or continue without knowing whether or not they’ll be reimbursed, experts say.
The letter sent by hundreds of organizations Tuesday — including the American Medical Association, Alliance for Connected Care, Cleveland Clinic and Intermountain Health — argues lawmakers’ “cycle of temporary fixes” has left providers and patients facing frequent care disruptions.
“The breadth of support behind this letter shows just how critical permanent Medicare telehealth policy has become to patients and providers alike,” Chris Adamec, executive director of telehealth association the Alliance for Connected Care, said in a statement. “We cannot continue relying on short-term extensions that leave clinicians and seniors in limbo.”
Meanwhile, another telehealth cliff is on the horizon. Pandemic-era flexibilities that allowed clinicians to prescribe some controlled substances without first conducting an in-person appointment are slated to expire soon.
These flexibilities were most recently extended through 2025. Days before President Joe Biden left office, his administration proposed a framework that would govern telehealth prescriptions for controlled substances, but some industry groups argued the regulation would be too onerous for providers and the rule hasn’t been finalized.
Extending the prescribing policies again would give regulators more time to make critical changes to the proposal, ATA Action, the advocacy arm of the American Telemedicine Association, said.
“The administration has the authority to extend it immediately, regardless of the shutdown, to protect patients, providers, and access to lifesaving treatment,” Kyle Zebley, executive director of ATA Action, said in a statement. “We urge Congress and the administration to take swift action to do so and to work with the telehealth community on a permanent, practical, and patient-centered regulatory framework.”
