$1.5 Trillion Omnibus Spending Bill Leaves Out Home Health Telehealth Reimbursement

The U.S. House of Representatives passed a comprehensive $1.5 trillion omnibus spending package on Wednesday. The legislation, among other things, extends the temporary virtual care flexibilities that were put in place during the public health emergency.

The bill will extend the waiver allowing hospices to perform face-to-face recertification visits through telehealth for five additional months after the end of the federally declared public health emergency.

Though the legislation gives hospice providers more room to breathe, the legislation makes no explicit mention of home health care. 


The extension also keeps the home as an originating site for telehealth services without geographic restriction. While this is important for care in the home, it doesn’t directly impact Medicare-certified home health agencies.

The inclusion of the telehealth extension is, in part, due to the advocacy efforts of the National Association for Home Care & Hospice (NAHC). The organization teamed up with other hospice stakeholders to push for this measure.

Still, NAHC stressed the importance of going further and making the telehealth extension a permanent fixture in Medicare.


“We are very pleased to see the extension of the telehealth waivers in the bill as they have proven extremely valuable during the pandemic,” William A. Dombi, president of NAHC, told Home Health Care News in a statement. “Our hope is to see these become permanent parts of Medicare in the future. Also, we anticipate further legislative opportunities this year to deal with sequestration as well as our Choose Home bill among other crucial matters.”

With flexibilities granted, telehealth became a staple among home health providers amid the COVID-19 emergency. 

In general, telehealth use has increased by more than 38 times since pre-pandemic baselines, according to data from McKinsey.

Despite this, home health stakeholders advocating for telehealth reimbursement have not seen large-scale progress on this front.

Last year, lawmakers introduced S. 1309, the newer version of the Home Health Emergency Access to Telehealth (HEAT) Act. Prior to that, the HEAT Act had been introduced in both the House and Senate during the previous year. 

The HEAT Act allowed telehealth services to substitute for in-person home health services and to be counted as visits for the purposes of Medicare reimbursement during a public health emergency. 

Organizations such as LeadingAge have supported The HEAT Act, but the legislation hasn’t seen much traction.

Additionally, in 2020, the Centers for Medicare & Medicaid Services (CMS) finalized changes to Medicare Advantage (MA) and Medicare Part D that aimed to beef up access to telehealth services.

Back in 2019, a group of senators introduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act.

The legislation aimed to expand Medicare coverage for telehealth services and require the Medicare Payment Advisory Committee (MedPAC) to report on which telehealth services would be appropriate for home-based care.

Some home health providers have been able to bill for palliative care remote patient monitoring under Medicare Part B.

Ultimately, many home health agencies have provided telehealth without being fully reimbursed for their services.

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