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House Committee Vote Gives Hope to Extending Telehealth, Hospital at Home Waivers

Analysis  |  By Eric Wicklund  
   May 09, 2024

The House Ways and Means Committee has approved a bill that would extend CMS pandemic-era telehealth waivers another two years and the Acute Hospital Care at Home waiver another five years

While prospects look dim for making pandemic-era telehealth waivers permanent, a bill before Congress could at least extend some flexibilities and one popular program beyond the end of this year.

The House Ways and Means Committee has voted to advance the Preserving Telehealth, Hospital and Ambulance Access Act (HR 8261), which would, among other things,  continue pandemic-era Medicare waivers enacted by the Centers for Medicare and Medicaid Services (CMS) for telehealth access and coverage through 2026 and extend the CMS Acute Hospital Care at Home waiver for an additional five years, to the end of 2029.

Those waivers had been set to expire with the end of the COVID-19 Public Health Emergency but were continued to the end of this year.

With regard to telehealth waivers, the proposed legislation would waive geographic and originating site restrictions on telehealth delivery, enable federally qualified health centers (FQHCs) and rural health clinics (RHCs) to use telehealth, expand the list of providers able to use telehealth, allow providers to use audio-only telemedicine platforms, such as the phone, and enable behavioral health providers to treat patients via telehealth without a required initial in-person evaluation.

In addition, the bill would give health systems five more years to seek reimbursement from Medicare for Hospital at Home programs that meet the requirements of the AHCaH waiver. More than 300 health systems are currently running programs that meet the CMS requirements.

[Read also: Congress Eyes Expansion of Hospital at Home Care Model.]

Supporters say the House committee’s markup and approval of the bill is good news at a time when positive steps forward are hard to find. A number of bills before Congress have sought to make the telehealth and Hospital at Home waivers permanent, but despite seeing widespread support on both sides of the aisle, none of those bills appear to be going anywhere this year.

“While we prefer Medicare telehealth flexibilities be made permanent, we understand the dynamics and applaud the Committee for a two-year extension of many of the critical flexibilities without arbitrary and unnecessary guardrails such as in-person requirements,” Kyle Zebley, senior vice president of public policy for the American Telemedicine Association and executive director of ATA Action, said in a press release.

Zebley pointed out that the committee’s markup and approval of the bill isn’t a guarantee that Congress will pass or even vote on the bill. He also noted that some proposals, including one that would ease rules around the use of telehealth to prescribe controlled substances, were left off the passed bill.

“This is not over yet,” he said. “There will be additional markups and other committees need to weigh in, as we continue to push for telehealth permanency.”

Eric Wicklund is the associate content manager and senior editor for Innovation at HealthLeaders.


KEY TAKEAWAYS

During the pandemic, CMS enacted several waivers aimed at expanding telehealth access and coverage. Those waivers are set to expire at the end of this year.

A separate waiver established Medicare reimbursement for the CMS Acute Hospital Care at Home model, which more than 300 health systems are now using.

While virtual care advocates support making those waivers permanent, a bill before Congress would extend the telehealth waivers for two years and the Hospital at Home waiver for five years.


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