Telehealth and Medicare

March 9, 2022

Article below discusses a draft of provisions expected to be included in a funding package that will come before Congress today or tomorrow, to avert a March 11 federal shutdown.   Article also mentions that the current federal Public Health Emergency (PHE) could end on / about July 15.  Finally, see red highlighted text (below).


Congress to temporarily extend Medicare telehealth coverage in funding package


Congress will include a months-long extension of telehealth flexibilities in a package to fund the government, fulfilling a key ask made by providers and advocates.

Under a draft of the provisions obtained by Modern Healthcare, Medicare will cover an array of telehealth services for at least 151 days after the end of the public health emergency, allowing beneficiaries to continue accessing care from their homes, at least temporarily.

That will allow Congress more time to study the impacts of expanding telehealth access under Medicare and to decide whether lawmakers want to make those changes permanent.

Before the pandemic, Medicare coverage of telehealth was fairly limited. But with the pandemic came an explosion of telehealth usage as people became afraid to seek care. It forced Medicare to update its coverage policies, and stakeholders have argued those changes should be made permanent.

Under the public health emergency, Medicare has temporarily waived several restrictions on coverage, including a requirement that beneficiaries be at a rural healthcare facility to receive telehealth services. Many of those waivers expire at the end of the public health emergency, which could end as soon as July 15.

Congress has been pushed by providers and telehealth advocates to permanently repeal those restrictions, but due to concerns about fraud and abuse, lawmakers decided to extend the flexibilities temporarily to allow for more time to collect data on costs and utilization.

The package directs the Medicare Payment Advisory Commission to release a report by June 15, 2023 detailing telehealth utilization in Medicare and costs. Congress will also direct the Office of the Inspector General to submit a report by the same date on program integrity risks associated with Medicare coverage of telehealth.

Under the temporary extension, federally qualified health centers and rural health clinics will be allowed to offer telehealth for 151 days after the public health emergency.

Medicare will continue to cover occupational and physical therapy as well as speech-language pathology delivered through telehealth during the 151-day period.

The package will also delay requirements that Medicare beneficiaries using telehealth for mental health services be examined in person by the provider within six months of starting treatment, and every year after.

The requirement, which was included in the government funding bill passed in 2020, was criticized by healthcare providers as a barrier to mental healthcare, especially for people in rural areas.

The package would also temporarily extend Medicare coverage of audio-only telehealth services.