On Tuesday, the release of a $1.7 trillion year-end spending bill was announced, aiming to prevent a government shutdown. The bill includes several healthcare provisions, most notably the extension of telehealth and hospital-at-home waivers and the reduction of the 2023 Medicare payment cuts from 4.5 percent to 2 percent.
Telehealth supporters have won a major victory with the passing of this new bill. This bill extends the telehealth-related regulatory flexibilities for Medicare beneficiaries, which were put into action during the COVID-19 pandemic, for two years. Before this bill, these flexibilities were only set to remain in place for five months after the public health emergency was over. Now, if the bill is approved by both the House and the Senate and enacted into law, the waivers will be valid until December 31, 2024.
These flexibilities include the elimination of geographic restrictions on originating sites for telehealth services. This means Medicare recipients can now receive services from any location. Additionally, federally qualified health centers and rural health centers will be able to continue offering telehealth services. The waivers also lift the initial in-person care requirements for those receiving mental health care through telehealth, and audio-only telehealth services will remain covered.
The proposed legislation aims to prolong the Medicare telehealth waivers and also, the Acute Hospital Care at Home Program for a period of two years. The program, introduced in November 2020 by the Centers for Medicare and Medicaid Services, allows for common acute conditions to be treated in the home setting, and is currently being utilized by 259 hospitals in 37 states. The bill would also extend the safe harbor for telehealth coverage for those with high deductible health plans (HDHPs) and health savings accounts (HSAs) for two years, allowing them to utilize telehealth services without having to meet their annual deductible first. While the bill does not include an extension of the Ryan Haight Act waiver, it does require the DEA to create regulations on the circumstances under which a special registration for telemedicine may be issued. This will hopefully provide more opportunities for telehealth services to become more widely available.