Congress Seeks to Extend COVID-19 Telehealth Flexibilities Through 2026 and Expand Reimbursement

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Sheppard Mullin Richter & Hampton LLP

[co-author: Gabriela Garcia-Bou*]

On May 16, 2024, the Subcommittee on Health of the House Committee on Energy and Commerce (the “Subcommittee”) announced that it advanced the Telehealth Modernization Act of 2024 (H.R. 7623) as amended (the “Bill”) during a markup session. The Bill is meant to extend a number of telehealth flexibilities under Medicare through 2026. This corresponded with 22 other bills advanced by the Subcommittee to strengthen access to healthcare.

The Bill largely seeks to continue Medicare’s hospital-at-home program through 2029, which provides resources for at-home care for patients who need acute-level care. The Bill would also eliminate the geographic originating site restrictions on telehealth visits through 2026. Absent these changes, the programs will expire at the end of 2024.

Significantly, the Bill also would empower the Secretary of Health and Human Services (“HHS”) to expand the categories of practitioners that may furnish reimbursable telehealth services. This would potentially allow for any healthcare professional who bills the Medicare program to be eligible to offer telehealth services. The Bill would further enable the Secretary to maintain an expanded list of eligible telehealth services, even after the existing law’s emergency period expires.

The Bill specifically benefits patients located in a rural location by explicitly allowing additional resources to be allocated to rural health clinics providing telehealth services. For example, the Bill would make permanent the ability of Federally Qualified Health Centers and Rural Health Clinics to provide telehealth services and provide reimbursements in those settings. This is crucial because Federally Qualified Health Centers and Rural Health Clinics are critical safety-net providers of primary care for underserved populations. Permitting these types of health centers to provide telehealth services as distant sites plays a major role in expanding and maintaining access to care in underserved and rural communities, and helps ensure continuity of care in those communities.

While the Subcommittee advanced the Bill following its markup session, it still must pass in both the House and Senate. Providers should closely track the Bill’s progress. If it is not enacted in 2024, the telehealth flexibilities borne out of the COVID-19 public health emergency may end. Practitioners should be prepared to adjust their telehealth services and billing practices in the event the flexibilities expire. On the other hand, practitioners should be prepared to continue and potentially expand their telehealth services and flexibilities if the Bill is enacted and the Secretary expands the applicability of the flexibilities to additional categories of healthcare professionals.

The population of Medicare patients that use telehealth has grown, likely in part due to the flexibilities—12% of Medicare users had a telehealth service in the third quarter of 2023, which is nearly double the percentage that received at telehealth service in the first quarter of 2020. If the flexibilities end, many Medicare patients who have grown accustom to telehealth will need to readjust how they seek out and receive healthcare services and providers will need to reassess how to best serve those patients.

*Gabriela Garcia-Bou is an associate in the Corporate Practice Group in the firm's New York office.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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