In a significant move to sustain healthcare accessibility, Congress has included a two-year extension of telehealth flexibilities within Medicare, as outlined in the recently proposed budget bill. This extension ensures that Medicare beneficiaries will continue to have access to a broad range of telehealth services, maintaining the expanded coverage initiated during the COVID-19 pandemic. The legislation also includes a five-year extension of the hospital-at-home program, supporting the delivery of acute care services in patients' homes.

While this extension is a positive development, it serves as a temporary solution. Healthcare access should not be subject to expiration dates. Permanent legislative action is essential to ensure continuity of care, encourage long-term investment, and address health disparities. The ultimate goal remains for the COVID-19-era flexibilities to be made permanent to facilitate greater long-term investment in virtual care for the betterment of patients.

What the Congressional Budget Bill Proposes

The budget bill contains several key provisions aimed at safeguarding telehealth access and advancing healthcare delivery:

Two-Year Extension of Telehealth Flexibilities

The two-year extension preserves critical telehealth services for Medicare beneficiaries, solidifying the gains made during the pandemic. Patients will continue to access virtual care for behavioral health, chronic condition management, preventive services, and more. These flexibilities also waive geographic and originating site restrictions, ensuring that care can be delivered in patients’ homes, regardless of location.

Additionally, the bill maintains Medicare reimbursement parity for telehealth services, allowing providers to receive equivalent payments for virtual and in-person visits. This provision is crucial for encouraging providers to offer telehealth services without financial disincentives.

Hospital-at-Home Programs

A five-year extension of the hospital-at-home program ensures that patients can receive acute-level care in their homes. This program reduces the burden on hospital resources, lowers healthcare costs, and improves patient satisfaction. With this extension, Medicare will continue to reimburse for services like intravenous therapy, remote monitoring, and physician consultations provided at home.

Broadband and Infrastructure Support

The bill addresses the digital divide by allocating funds for broadband expansion, particularly in underserved and rural areas where telehealth access has been limited by poor connectivity. Reliable internet infrastructure is essential for the success of telehealth programs, enabling patients and providers to connect seamlessly and securely.

Equity in Telehealth Access

The legislation emphasizes equitable access to telehealth services, particularly for marginalized and vulnerable populations. Provisions include targeted support for low-income communities and measures to address disparities in digital literacy and technology adoption.

Additional Provisions

Remote Patient Monitoring (RPM): The bill continues support for RPM programs, enabling patients with chronic conditions to monitor their health from home and share real-time data with their providers.
Mental Health Services: It mandates continued integration of telehealth into behavioral health treatment, addressing the escalating demand for mental health care.
Telehealth for Substance Use Disorders: The bill retains flexibility for telehealth-based substance use disorder treatments, a critical measure amid the ongoing opioid crisis.

Why Telehealth Flexibilities Matter

For Patients

Access to Care: Telehealth has been a lifeline for patients in rural and underserved communities, eliminating the need for long travel times and addressing provider shortages.
Mental Health Services: Behavioral health and substance abuse treatment via telehealth skyrocketed during the pandemic, offering discrete and convenient access to care.
Chronic Disease Management: Remote patient monitoring (RPM) programs allow patients with conditions like diabetes or hypertension to manage their health effectively from home.

For Providers

Expanded Reach: Providers can offer care to more patients, including those who might otherwise forgo treatment due to distance or mobility issues.
Operational Efficiency: Virtual visits reduce overhead costs and free up physical office space for procedures requiring in-person care.

For the Healthcare System

Cost Savings: Telehealth reduces emergency room visits and hospital readmissions, lowering overall healthcare costs.
Increased Efficiency: By shifting routine and follow-up care to virtual platforms, healthcare systems can better allocate resources to critical cases.

The Risks of Expiration

Without congressional action, the expiration of telehealth flexibilities would have had profound consequences:

Medicare Patients Face Disruptions
Approximately 67.4 million Medicare beneficiaries were at risk of losing access to telehealth services, particularly in rural areas where provider shortages are most acute.
Provider Burdens
Telehealth providers would have faced increased operational challenges, including compliance with pre-pandemic regulations like the Ryan Haight Act. This law requires in-person evaluations before prescribing controlled substances—a significant barrier for many patients.
Public Health Setbacks
The progress in expanding healthcare access and reducing disparities could have been undone, particularly in behavioral health and chronic disease management.

Why a Two-Year Extension is a Step Forward

The proposed two-year extension offers several advantages:

Time for Adaptation: Providers and healthcare systems will have additional time to adjust workflows and implement permanent telehealth programs.
Policy Refinement: The extension provides Congress with a window to evaluate the efficacy of telehealth flexibilities and gather data to inform long-term legislation. CTeL is actively working on research to ensure that by 2026, the research is in place to support permanency.
Patient Continuity: Millions of Americans will continue to access care without disruption, maintaining critical services for vulnerable populations.

Permanency is the Ultimate Goal

While the two-year extension is a vital stopgap, temporary measures are not enough. Healthcare access should not have an expiration date. By 2027, Congress must enact permanent telehealth legislation for the following reasons:

Stability for Patients and Providers
Permanent policies eliminate uncertainty, allowing providers to invest in telehealth infrastructure and ensuring patients can rely on uninterrupted care.
Equity in Healthcare
Telehealth has been instrumental in addressing disparities, but inconsistent policy threatens to widen gaps in access, particularly for marginalized communities.
Innovation and Growth
A stable regulatory environment fosters innovation, enabling the development of advanced telehealth technologies and expanding the scope of services.

Call to Action

The two-year extension in the congressional budget bill is a critical step, but it is only the beginning. Policymakers, healthcare providers, and advocates must work together to secure permanent telehealth legislation. Millions of Americans depend on telehealth for their health and well-being, and it is incumbent upon Congress to ensure that these services remain accessible and sustainable.

Healthcare is a fundamental human need—its delivery should not be constrained by arbitrary timelines. Let’s ensure telehealth becomes a permanent fixture in the American healthcare system. The ultimate goal must remain clear: permanent telehealth legislation by 2027, ensuring that healthcare access is seamless and uninterrupted for all Americans.

The ultimate goal must remain clear: permanent telehealth legislation by 2027, ensuring that healthcare access is seamless and uninterrupted for all Americans.

Join the Effort

Whether you’re a patient, provider, or policymaker, your voice matters. Advocate for permanent telehealth legislation by contacting your representatives and supporting organizations working toward this critical goal. Together, we can ensure that healthcare access is equitable, continuous, and enduring.

Tangibly, you can support and fund CTeL research to make sure Congress knows the full picture of how beneficial telehealth is to the broader health of our nation. For more information, click here.

Telehealth Secures a Lifeline: Two-Year Extensions Make the Cut in Year-End Congressional Budget