Telehealth Extension: A Mixed Blessing for Providers

On March 15, Congress approved a federal spending bill that extends telehealth provisions through September 30, 2025. This extension is a significant win for virtual care advocates, as it maintains access to essential healthcare services for millions of Americans. However, this good news comes with a bittersweet aftertaste: lawmakers failed to reverse cuts in Medicare payments to physicians, leaving many in the medical community frustrated and concerned about the future. 

Key Provisions of the Telehealth Extension 

The newly passed spending bill includes several key elements aimed at enhancing access to telehealth services: 

1. Removal of Geographic and Originating Site Restrictions: Patients can now receive telehealth services from various locations, including their homes, regardless of where they reside. This change helps eliminate barriers that previously restricted telehealth access for patients living in rural or underserved areas. 

2. Expansion of Authorized Healthcare Practitioners: The bill broadens the range of healthcare professionals who can provide telehealth services, ensuring that more patients can receive the care they need from qualified providers. 

3. Eligibility for Federally Qualified Health Centers and Rural Health Clinics: These facilities will continue to be eligible to furnish telehealth services, further supporting access to care for vulnerable populations. 

4. Delay of In-Person Visit Requirements for Mental Health Services: The legislation postpones the implementation of in-person visit requirements for mental health services delivered via telehealth, allowing patients to receive care without the added stress of unnecessary in-person appointments. 

5. Authorization of Audio-Only Telehealth Services: The bill maintains the use of audio-only telehealth services and extends telehealth for hospice care recertification, ensuring that patients can continue to access critical support without the need for video technology. 

A Significant Victory for Patients and Providers 

Kyle Zebley, executive director of ATA Action, celebrated the passage of the bill, stating, “With this vote last night, Congress has prevented millions of Americans from being cut off from essential healthcare services. We have avoided a shutdown for telehealth services. This is a big victory for telehealth and a huge relief for patients and clinicians in every state and region of the United States, especially those in underserved communities.” 

The extension of the Acute Hospital Care at Home program is another crucial aspect of the bill, allowing Medicare-certified hospitals to continue providing inpatient-level care in patients’ homes. This program has proven invaluable in recent years, especially during the COVID-19 pandemic, as it enables healthcare providers to deliver care in a more flexible and patient-centered manner. 

A Long-Term Concern for Telehealth Advocates 

Despite the positive developments, telehealth advocates find themselves in a familiar predicament. The short-term nature of the extension raises concerns about the future of virtual care programs. Healthcare groups must now prepare for another deadline just months away, which could disrupt access to telehealth services if Congress fails to act again. 

Zebley noted that the uncertainty surrounding funding and program continuity makes it challenging for healthcare organizations to plan for the long term. The desire for a multi-year extension was palpable among telehealth advocates, who had hoped that Congress would recognize the critical importance of virtual care and take steps to ensure its sustainability. 

The Ongoing Challenge of Medicare Payment Cuts 

While the extension of telehealth services is a welcome relief, the failure to address cuts in Medicare payments to physicians remains a pressing concern. The Centers for Medicare & Medicaid Services (CMS) had previously approved a 2.8% reduction in payments to doctors for 2025. Medical groups had implored Congress to prevent these cuts or at least soften their impact, but the spending package did not provide any relief. 

Anders Gilberg, senior vice president of the Medical Group Management Association, criticized lawmakers for their inaction. “The passage of the CR without a Medicare physician payment fix represents a massive congressional failure and blatant abdication of duty to our nation’s physicians and their beneficiaries,” Gilberg stated. The growing frustration among doctors is evident, as many have voiced concerns about the implications of these cuts on patient access to care. 

The Ripple Effects of Payment Cuts 

The repercussions of Medicare payment cuts extend beyond financial strain for physicians. Many doctors report that these reductions prompt them to stop accepting Medicare patients, leading to decreased access to care for vulnerable populations. Independent practices are also at risk, with some considering closure due to unsustainable payment structures. 

The Medical Group Management Association has been vocal in its efforts to persuade Congress to revamp Medicare’s payment formula. Advocates argue that mechanisms should be implemented to account for inflation, ensuring that physicians are fairly compensated for their services. Gilberg emphasized the need for permanent, sustainable solutions to avoid annual chaos, stating, “Congress must realize permanent, sustainable solutions, such as implementing an annual, inflation-based physician payment update tied to the full Medicare Economic Index and modernizing Medicare’s antiquated budget neutrality policies.” 

Calls for Reform from the Medical Community 

The American Medical Association (AMA) has echoed similar sentiments, urging lawmakers to enact reforms that address the underlying issues within Medicare’s payment system. Dr. Bruce A. Scott, president of the AMA, emphasized the necessity for fundamental reforms, stating, “Medicare is broken. Under financial stress, burnout has become an occupational hazard for physicians. As these cuts pile up year after year, more and more physicians are closing their practices, leaving patients without access.” 

Telehealth and Physician Payments 

The recent extension of telehealth services is undoubtedly a step in the right direction. However, the lack of action on Medicare payment cuts poses a significant challenge that cannot be overlooked. It is crucial for lawmakers to recognize the vital role that physicians play in delivering healthcare and to take steps to ensure that they are adequately compensated for their services. 

The medical community must remain vigilant and advocate for sustainable solutions that address the challenges posed by payment cuts while continuing to support the expansion of telehealth services. As we look toward the future, it is essential to foster an environment that prioritizes patient access to care and the financial stability of healthcare providers. By doing so, we can ensure that telehealth remains a viable option for patients and providers alike, ultimately enhancing the quality of care for all Americans.