When shutdown ends, telehealth extension likely won’t last long

The federal government shutdown has now lasted for more than a month, going beyond any other shutdowns.

The shutdown has disrupted telehealth programs, with Medicare waivers expiring because they were tied to the last spending bill that financed the federal government.

Hospital-at-home programs have also been affected by the expiration in federal waivers for telehealth. The Centers for Medicare & Medicaid Services has told hospitals that patients getting acute care at home were to be transferred to brick-and-mortar facilities or discharged.

Kyle Zebley, senior vice president of public policy for the American Telemedicine Association, talked with Chief Healthcare Executive® about the shutdown and the impact for telehealth programs. He also explained that Congress will likely sign off on a short-term spending bill to end the shutdown, and telehealth waivers will probably mirror the length of that legislation.

In an excerpt from our conversation, Zebley makes the case for permanent reform or, at least, a multi-year extension. But it’s likely the extension will only last for months.

Q: We're still waiting for a resolution of the shutdown, but any resolution is likely just going to be another short-term spending bill. It means not too long down the road, even if they solve this tomorrow, probably a couple months from now … we're hoping for either more permanent reform, or at least a multi-year extension, or an annual appropriation. Is there any evidence to suggest we're going to get anything other than a short-term extension out of all of this?

A: “Well, again, anything's better than where we are.”

“If we were to forecast what will happen next, I think the scenario you laid out of a short-term funding bill, having attached to it a short-term extension of the Medicare telehealth flexibilities and acute hospital care at home. That's how it works now, unfortunately and has worked for a few decades, and it’s getting worse every year. So yeah, we probably will be back in that circumstance, at the very least for this next measure that will reopen the federal government.”

“And by the way, it's going to happen. It will happen. And so what again, makes it all the more frustrating is the fact that we've got to go through the pain in order to get through the conclusion that we all knew was inevitable. Could they have just done this right before the shutdown? But I guess the pain is the point, as the two parties are at loggerheads."

“But 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. And again, I say that, totally understanding our bipartisan support, being so grateful for it. Never will we as a community take that for granted. But despite all that support and despite all that gratitude that we've shown for it, we still have ended up the victim here."

“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."