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Telehealth extensions may not happen until late in the year

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Advocates are confident that Congress will ultimately agree to continue virtual health flexibilities, but lawmakers may not seal the deal until after the election.

Telehealth advocates have said this year represents the Super Bowl for virtual healthcare, and the game is about at halftime.

Image: American Telemedicine Association

Kyle Zebley, senior vice president of public policy for the American Telemedicine Association, says he's confident lawmakers will approve telehealth extensions. But he says advocates should urge Congress to act.

On the upside, telehealth leaders remain confident that Congress will approve legislation that would allow health systems and providers to continue offering virtual care and hospital-at-home programs.

But lawmakers may not act until late in the fourth quarter.

Kyle Zebley, senior vice president of public policy for the American Telemedicine Association, says he remains optimistic that lawmakers will continue the telehealth extensions.

“It's going to get done,” Zebley tells Chief Healthcare Executive®. “It's just going to really be stressful in the act of getting done.”

The federal government eased restrictions on telehealth in the early days of the COVID-19 pandemic, and President Biden and lawmakers have kept them in place. Lawmakers and Biden brokered extensions late in 2022. Those extensions expire at the end of 2024.

Telehealth advocates have urged the federal government to enact permanent reforms. Zebley says he remains an optimist that permanent reforms will eventually happen.

But he says at this point, Congress is more likely to approve another extension for a couple of years.

“I think it's safe to say that it's going to be an extension, not permanency,” Zebley says. “And I think it really does get chalked up to the idea that this is how Congress operates. We're not the first to be caught in an extension loop. And again, it's far preferable to permanently going away. So it's far better than nothing.”

The U.S. House Energy and Commerce Subcommittee on Health approved a bill last month that would extend telehealth programs. The Telehealth Modernization Act, which has bipartisan sponsorship, continues many telehealth flexibilities for an additional two years.

The measure would offer a five-year extension for hospital-at-home programs. The American Hospital Association has endorsed the legislation.

In the wake of the pandemic, more hospitals have begun offering acute care at home.

As of May 13, there were 330 hospitals, across 136 health systems, offering hospital-at-home programs, according to the Centers for Medicare and Medicaid Services.

Healthcare leaders say more hospitals are likely to begin offering acute care at home if they have assurance that the government will reimburse such services. Zebley says that’s why lawmakers are looking for a five-year extension for home hospital programs.

“I think they want to get that certainty for hospital at home,” Zebley says.

While Zebley says advocates are hoping lawmakers will move sooner than later, several factors suggest the package won’t be done until late in the year.

Congress typically takes a recess in August, and most lawmakers are running for re-election in the fall. So it’s likely lawmakers won’t take up the legislation until after the election.

Lawmakers are likely to include the telehealth measures in broader healthcare spending legislation, Zebley says.

While he’s confident the telehealth legislation will be approved, Zebley says the situation is still producing anxiety for health systems, telehealth providers and patients.

“Healthcare systems make appointments a year in advance,” Zebley says. “We're going to be a stone's throw away from this thing expiring, potentially, before Congress takes action. The Christmas decorations will likely be up if our predictions are true.”

Given the rush to get many key spending bills done at the end, Zebley says advocates will be glad to see the telehealth extensions approved, even if they fall short of permanent reforms.

“We wish it was permanent,” he says. “It'll probably be an extension. And we wish that they'd act sooner, but will probably do it later. We wish that it would include a whole host of top priorities for the telehealth community. They'll probably not include them all. But bottom line answer, we’re very, very confident that Congress would not allow this to lapse.”

Still, Zebley says, “We can't take all that great bipartisan, bicameral support for granted. We can never take it for granted, and we can't assume that will be enough.”

Telehealth advocates, including hospital leaders and patients, should press lawmakers to support an extension, Zebley says.

“Get on the field in this telehealth Super Bowl,” Zebley says. “Don't assume that public policy is a spectator sport. It requires participation. Don't expect other people to do the work for you. Despite all my optimism, I'm still nervous, and you should be too.

“Whether or not you're a patient, or provider, or a loved one of a patient or provider, you should have skin in this game,” he says.

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