Legislation To Extend PHE Telehealth Flexibilities Passes In Near-Unanimous House Vote

A bill that would extend telehealth waivers until the end of 2024 has been passed by the U.S. House of Representatives.

The news is notable because it means that these pandemic-relief telehealth flexibilities could be untied from the public health emergency (PHE). Currently, the PHE is set to expire in October, but could receive another extension.

On Tuesday, the House Rules Committee advanced the Advancing Telehealth Beyond COVID-19 Act in an almost unanimous vote.

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“We saw telehealth services widely and successfully adopted during the COVID-19 pandemic, now we must ensure those services are here to stay,” Congresswoman Debbie Dingell (D-Mich.) said in a statement. “For seniors, traveling to a doctor’s office can be a prohibitive barrier to receiving the care they need, and we cannot allow people who have come to rely on telehealth throughout the pandemic to have that resource taken from them. This legislation brings us one step closer to permanently expanding telehealth services and allowing Americans to continue to access critical health care from the comfort of their home.”

The National Association for Home Care & Hospice (NAHC) has thrown its support behind the legislation.

“The bill gives Congress, Medicare and stakeholders time to produce a permanent policy with any necessary program integrity measures and benefit qualifications on a complex set of issues,” NAHC President William A. Dombi said. “For home health and hospice, it preserves, at least temporarily, the very valuable option of telehealth visits to meet the face-to-face encounter requirements under the respective benefits.” 

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The legislation would keep in place the increase in the geographic locations where Medicare beneficiaries can receive telehealth services. It would also keep in place the ability to conduct face-to-face encounters – through the use of telehealth – prior to the recertification of care.

Before this flexibility was in place, patients were required to have an in-person doctor’s appointment before they could receive home health services.

Prior to the extension of the PHE earlier this month, the potential loss of telehealth flexibilities was a top concern for home health providers.

Some noted that the new rules allowed providers to enhance care delivery and increase access to care at a time when organizations were struggling.

“CMS’ easing of face-to-face rules during the early days of the public health emergency helped save lives as the pandemic emerged.” Brent Korte, chief home care officer at EvergreenHealth Home Care, previously told Home Health Care News. “Allowing virtual face-to-face visits in all circumstances streamlined access to home health and kept patients from taking beds in overwhelmed hospitals. This also helped increase access to home health and significantly improved timeliness of care. It helps to reduce duplicative care and even unnecessary visits when patients have to do an in-person visit.”

The legislation arguably goes a long way in regards to easing the concerns of providers.

One thing that remains unaddressed, however, is the ability for home health providers to receive reimbursement under Medicare for telehealth services.

In the past, some providers have delivered telehealth without receiving full pay for these services.

“Both in home health and in hospice, [agencies] delivered telehealth services quite robustly during the pandemic for free,” Dombi previously said. “And so now the next expectation is [they’ll] always do it for free.”

Though a number of providers have taken the position that telehealth services are worth the long-term investment, providers want to be paid for the care they provide.

The legislative efforts around home health telehealth, which have been stalled and unsuccessful, stand in the way of this.

Dombi believes that this bill may open the door for this to change in the future.

“The extension also provides an opportunity to get additional changes in telehealth policy in place such as payment to home health agencies,” he said. “It essentially guarantees there will be a future legislative vehicle to do so, whereas Congress does not have the time to consider those changes now.”

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