Congress Passes 2-year Omnibus Telehealth Extension Bill

In the last hour of 2022, the Omnibus extension bill received congressional approval from both the House and Senate that would allow telehealth flexibilities to continue for two more years. The bill is currently awaiting President Joe Biden’s signature.

Those enrolled in Medicare have come to enjoy the ease and convenience of telehealth and its telemedicine services. Much of the coverage that was allotted over the last couple of years was in response to reducing the transmission of the COVID-19 virus, keeping immunocompromised patients safe and managing a major medical staffing shortage.

However, telehealth has grown on us, and providers, clinics and health systems have started to work it into their patient health care plans and practice. Over the last couple years, its use in mental and behavioral health became the preferable mode of treatment for certain populations as well as benefiting those suffering from chronic conditions, living in rural areas, providers facing burnout and more.

“The AHA is pleased that on a bipartisan basis Congress recognizes the immense pressure America’s hospitals, health systems and our caregivers are facing. This legislation will deliver critical support and resources so we can better care for our patients and create healthier communities,” said AHA President and CEO Rick Pollack in a media statement.

Although the bill does have an expiration date, it’s intended to give experts time to research and determine a more permanent solution.

Key takeaways from the telehealth extension bill:

• Beneficiaries continue to receive telehealth services at any site, regardless of type or location.

• Occupational therapists, physical therapists, speech-language pathologists, and audiologists can continue to furnish telehealth services.

• Federally qualified health centers and rural health clinics can continue to serve as the distant site (i.e., the location of the health care practitioner).

• Evaluation, management and behavioral health services can continue to be provided via audio-only technology.

• Hospice physicians and nurse practitioners may continue to complete certain requirements relating to patient recertifications via telehealth.

What does this mean for digital health companies?

While the bill is still waiting on presidential approval, it is likely the government will continue the telehealth Medicare flexibilities granted as a result of the pandemic. The legislation will extendthe Medicare-dependent hospital and enhanced low-volume hospital programs until Dec. 31, 2024. 

The push towards continued Medicare reimbursement for telehealth services, including audio-only telehealth, bodes well for those who offer virtual care services. 

The bill is simply a placeholder and has sparked discussions of a more permanent reimbursement on its way. As of right now, the Centers for Medicare and Medicaid and other governmental agencies don’t have enough research to settle on a permanent solution. The next two years will hopefully provide the data they need to legislate a more solidified reimbursement plan.

It's important to note that there is no discussion to phase out telehealth, in fact, this bill shows the opposite. Decision makers are simply trying to decide what it will look like as a permanent medical practice option. Currently, there are 64 million Americans covered by Medicare. Almost all of them being 65+ including younger people with disabilities or End Stage Renal Failure. All patients demographics that have shown to benefit the most from virtual care options.

Continued access to Medicare reimbursement means telehealth companies can offer more affordable virtual care services and lower the financial barrier to quality care for many patients.

Does this include Medicaid and private insurers?

Private payers and Medicaid are a little different and aren’t included in this current bill. The bill refers only to the federally run Medicare, leaving Medicaid and private insurer policies to the states to decide. Currently 43 states and the District of Columbia have some form of private payer policy toward telehealth services.

The National Conference of State Legislatures’ website has a great resource that shows which states currently hold policies and what they are.

As telehealth continues to prove its validity as a virtual care practice, providers and patients alike are turning to it as an alternative to in-person patient care. The bill indicates that the government and private insurers have taken notice of the demand for better healthcare options. Digital health companies and telemedicine providers have shown that telehealth can be cost effective without sacrificing the quality of care given to the patients.

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Note: This article will be updated as the bill progresses