Congress to grant 5-month extension for pandemic telehealth flexibilities with omnibus bill

Congress is set to grant a five-month extension to telehealth flexibilities created during the pandemic as part of a sweeping spending package filed by the House early Wednesday morning.

The extension would leave the flexibilities in place for 151 days after the end of the federal public health emergency, which currently expires in April but is expected to be extended into July.

The House plans to vote on the $1.5 trillion package Wednesday to put it to the Senate by Friday.

The telehealth accommodations extended by the omnibus bill allow adults aged 65 and up Medicare coverage for telehealth visits, including some audio-only visits, regardless of where the patient lives relative to the healthcare provider.

Previously, Medicare only reimbursed services for patients living in rural areas and only covered services provided by physicians and select practitioners.

Under the pandemic’s telehealth flexibilities, all Medicare-enrolled providers can bill for telehealth services, and Medicare covers telehealth visits that take place from the patient’s home as well as from medical facilities.

The bill will also postpone the requirement that older adults who seek virtual mental health care have an in-person visit within six months of the telehealth visit.

The provisions apply only to Medicare reimbursement for telehealth, but private insurers are likely to follow suit.

Negotiations on the omnibus bill stalled last week when the White House requested the package include $22.5 billion in COVID-19 relief as well as $10 billion in emergency aid to Ukraine.

The current draft in the House designates $13.6 billion to Ukraine. The Wednesday morning draft included $15.6 billion in pandemic relief, but House Speaker Nancy Pelosi (D-Calif) stated in a letter to party members in the afternoon that the COVID-19 funds had been cut from the bill entirely due to Republican pushback.

Stopgap funding will expire Friday night at midnight, but the House is expected to pass an extension through March 15 to give the bill sufficient time in the Senate and prevent a government shutdown.

Various bipartisan bills have been introduced since the start of the pandemic to make telehealth flexibilities permanent.

While these bills have received overwhelming public support, concerns about the risk of fraud with telehealth usage, unnecessary spending and worsened patient outcomes have hovered over lawmakers.

The omnibus bill proposes that the Medicare Payment Advisory Commission conduct a study about Medicare telehealth utilization, program expenditures on telehealth services, telehealth payment policies and the impacts of telehealth’s expansion during the pandemic on the access to and quality of care.

The Centers for Medicare & Medicaid Services would also display quarterly data on Medicare claims for telehealth services on its website beginning in July.

In addition to telehealth extensions, the bill includes provisions that would allow the Food and Drug Administration to regulate synthetic nicotine.

The drug, engineered in a lab rather than taken from tobacco plants, has risen in popularity as electronic cigarette companies like Puff Bar attempt to skirt FDA regulations on vaping products.