Telehealth gets a short extension, and faces a looming deadline

Telehealth programs are resuming normal operations with the reopening of the government, but there’s not much time for providers to savor the moment.

When Congress and President Trump signed off on legislation restoring the government, the bill included short-term extensions for telehealth and hospital-at-home programs. The legislation also allows retroactive payment for telehealth services when the waivers lapsed.

The shutdown disrupted telehealth and hospital-at-home programs for more than a month, because Medicare waivers for those programs lapsed when the previous government spending bill expired at the end of September. Some Medicare patients couldn’t utilize virtual care programs, while health systems were directed to transfer patients getting acute care at home to hospitals.

Under the new short-term spending bill, those telehealth waivers are back in place, but they last only until Jan. 30, when the legislation expires.

Kyle Zebley, and senior vice president of public policy for the American Telemedicine Association, said he is grateful for the restoration of the waivers. The legislation also allows retroactive payment for telehealth services when the waivers lapsed.

“This sends an important message to healthcare providers and patients, that our government leaders value telehealth and are committed to maintaining access to these urgently needed programs,” Zebley said in a statement.

But Zebley, who is also the executive director of ATA Action, the association’s advocacy arm, also acknowledged that the waivers give healthcare providers only a brief reprieve.

Without congressional action, health systems and other providers will be sweating over the prospect of another interruption to their ability to provide virtual care and acute care at home.

In a recent interview with Chief Healthcare Executive®, Zebley stressed the importance of eventually getting Congress and the Trump administration to sign off on permanent reforms. At the very least, telehealth providers would like to see an extension that lasts for years rather than months, he said.

“What I really, sincerely hope and have communicated to our members is that this lapse will be a rallying cry that will prove to policy makers the error of their ways,” he said.

“So I'm hoping that we can build a case for why we need permanency, and again, if not permanency, at the very least a multi-year extension of these flexibilities.”

Republicans and Democrats in Congress continue to demonstrate strong support for telehealth and virtual care programs, Zebley said. President Trump first approved waivers for telehealth programs during the emergence of the COVID-19 pandemic, and has remained a staunch supporter of those programs, he said.

Nonetheless, this is the third time in less than a year that lawmakers have had to approve a short-term extension of telehealth waivers. Lawmakers previously agreed on brief extensions in December 2024 and then again in March, and they were also tied to broader bills to fund the federal government.

Congress hasn’t been able to secure a long-term deal for telehealth since Congress and then-President Biden approved a two-year extension of telehealth programs that expired at the end of 2024.

Zebley told Chief Healthcare Executive in October that it’s time for providers and health systems to have some predictability when it comes to telehealth and hospital-at-home programs.

“What we have said is, after permanency, our next ask, obviously would be the longest extension possible,” Zebley said. “Get us out of these short-term extensions. Get us on firmer ground.”

The American Hospital Association says that some health systems have held off on launching hospital-at-home programs because of the uncertainty over federal support. Nationwide, 147 health systems, and a total of 419 hospitals in 39 states, are approved to provide acute care at home, according to federal data.

“Other health systems and hospitals have indicated they are interested in standing up hospital-at-home programs but are hesitant to do so without a long-term extension from Congress,” the association said last month.

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