CTeL Advocates for Telehealth Extension: Supporting Congresswoman Matsui’s Push for End-of-Year Action

As the December 31, 2024, expiration date for expanded Medicare telehealth coverage looms, the Center for Telehealth & e-Health Law (CTeL) is actively engaging with policymakers to ensure the preservation of vital virtual care services. In partnership with Congresswoman Doris Matsui’s office, CTeL encourages the House to incorporate telehealth provisions into the upcoming end-of-year appropriations package. The stakes are high: without legislative action, millions of Medicare beneficiaries risk losing access to telehealth services they have come to depend on.

The Urgency for Congressional Action

The COVID-19 pandemic catalyzed the rapid adoption of telehealth, highlighting its critical role in addressing healthcare disparities. During the public health emergency, Congress expanded Medicare telehealth coverage to include services delivered to patients in their homes and removed geographic restrictions, making care accessible to rural and underserved populations. These measures were extended temporarily in the Consolidated Appropriations Act of 2023, but they are set to expire at the end of this year​.

Congresswoman Matsui, a long-standing telehealth champion, has called for permanent reforms to ensure long-term stability and innovation in virtual care delivery. Her advocacy aligns closely with CTeL’s mission to advance telehealth policy and remove barriers to care. This year, bipartisan support has emerged in House committees to extend telehealth provisions for an additional two years—a crucial step toward more permanent solutions​.

Telehealth’s Transformative Impact

The benefits of telehealth extend far beyond convenience, providing substantial improvements in healthcare outcomes, cost savings, and accessibility. Research highlights its transformative role in reducing emergency department (ED) visits, improving medication adherence, and expanding access to mental and behavioral health services.

Improving Behavioral Health Access

Telehealth has become a cornerstone of mental health care, with nearly 40% of Medicare telehealth services focusing on mental health. This has led to more frequent therapy sessions and shorter wait times for patients who may otherwise face barriers to in-person care, such as long travel distances or stigma surrounding mental health services. The removal of restrictive in-person visit requirements is critical to maintaining these gains and ensuring continuity of care for vulnerable populations.

Emergency Department Diversion and Cost Savings

Telehealth interventions have demonstrated their ability to divert unnecessary ED visits, saving billions annually. Programs like "The Living Room" crisis stabilization center in New York show the potential for telehealth-enabled models to reduce ED costs significantly—from an average of $1,300 per visit to just $200. These savings are not only financial but also reduce stress for patients seeking immediate care.

Addressing Healthcare Gaps in Rural Areas

Telehealth bridges critical gaps in underserved and rural areas, where patients often struggle to access in-person healthcare due to a shortage of providers. Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) have played pivotal roles in this transformation, leveraging telehealth to deliver essential services. However, continued support for these institutions is crucial to sustain these advancements.

Broader Public Health Impact

Telehealth has proven especially effective during public health emergencies. For example, during COVID-19, telehealth allowed uninterrupted access to care for millions, minimizing infection risks while maintaining healthcare delivery. Beyond emergencies, its ability to streamline chronic disease management and enable remote patient monitoring can prevent complications, reduce hospital readmissions, and enhance patient satisfaction.

By making telehealth a permanent fixture in healthcare delivery, Congress can solidify its role as an essential tool for improving access, equity, and efficiency in the healthcare system. However, this will require legislative action to address remaining barriers, such as reimbursement challenges and broadband infrastructure deficits, to maximize telehealth’s potential for all communities.

Stronger Together

CTeL’s engagement with Congresswoman Matsui’s office underscores the organization’s dedication to ensuring that telehealth remains a cornerstone of modern healthcare delivery. Through ongoing advocacy, CTeL is pushing for provisions that would permanently remove geographic and site restrictions, expand provider eligibility, and enhance the use of telehealth in hospice care and other critical areas.

CTeL is also emphasizing the need for legislative certainty to encourage continued investment in telehealth infrastructure and innovation. Without clear, long-term policies, healthcare providers and organizations face challenges in planning and deploying effective virtual care solutions.

What Can I Do?

  1. Reach Out: Call, email, or write to your representative’s office and express your support for telehealth. Share how expanded telehealth access has positively impacted your practice, organization, or patients. Reference the letter below for additional support.

    • Find Your Representative: Visit the House of Representatives website to locate your representative's contact information.

  2. Highlight Key Points: CTeL has drafted an infographic to help support the need for telehealth expansion and permanency.

  3. Make it Personal: Stories resonate. If you have a personal or organizational experience that illustrates the value of telehealth, please include it. Personalized messages are more likely to grab attention and influence decision-making.

What’s at Stake

The stakes for telehealth are monumental as the potential expiration of key flexibilities looms at the end of 2024. If Congress does not act, millions of Americans could face barriers to care, disproportionately impacting rural, elderly, and underserved communities.

  1. Medicare Patients and Rural Communities: Over 63 million Medicare beneficiaries have benefitted from telehealth expansions, many of whom reside in rural areas without nearby healthcare providers. Losing telehealth options would force patients to travel long distances for in-person care or forego treatment entirely, exacerbating existing health inequities.

  2. Behavioral Health: Telemental health has been a lifeline, with a surge in demand since 2020. A study from JAMA Psychiatry revealed that telehealth visits accounted for 40-50% of all mental health appointments at the height of the pandemic. Without an extension of the Ryan Haight Act waiver, many patients will lose access to their behavioral health providers, as prescribing controlled substances remotely would again require an initial in-person consultation.

  3. Economic and Health System Impacts: For providers, losing telehealth reimbursement could lead to decreased revenue streams, especially for small practices and telehealth-only clinics. Additionally, health systems would see an increased strain as patients return to overburdened in-person settings, potentially causing delays in care.

  4. Cost Savings and Healthcare Access: Telehealth has demonstrated cost-efficiency by reducing unnecessary ER visits and hospital readmissions. A RAND Corporation study estimated that telehealth visits cost roughly 50% less than traditional visits, while also offering patients significant time savings.

  5. The Digital Divide: Although telehealth has been heralded as a step forward, disparities remain. Low-income and elderly populations often lack internet access or digital literacy, making the loss of audio-only telehealth options especially devastating. Data shows that nearly 26% of Medicare beneficiaries relied on audio-only services during the pandemic.

  6. Administrative Reforms at Risk: The expiration of flexibilities would also reinstate administrative burdens, such as in-person enrollment visits for Medicaid and complex reimbursement rules for providers, potentially discouraging participation in telehealth programs.

In summary, the stakes are not just about maintaining the status quo. Telehealth has fundamentally transformed healthcare delivery, and its potential rollback threatens to undo years of progress in expanding access, improving outcomes, and reducing costs. Swift action from Congress is essential to secure these gains for the future. If Congress fails to act, the progress made in telehealth over the past four years could be jeopardized, leaving millions of patients—especially seniors and those in underserved areas—without access to care. The telehealth community, including CTeL and its partners, remains optimistic that bipartisan support will pave the way for a year-end package that prioritizes these critical services.

By joining forces with policymakers like Congresswoman Matsui, CTeL is ensuring that telehealth remains not just a pandemic-era innovation but a permanent fixture in the American healthcare landscape.

For more information on CTeL’s advocacy in action, click here.

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