Lawmakers say they are confident Congress will extend expanded telehealth authorities past a looming deadline next month — but they have no idea how and could not rule out a lapse.
In 2020, Congress and President Donald Trump temporarily expanded Medicare reimbursement for services clinicians provide remotely as part of the response to the COVID-19 pandemic. Lawmakers have hailed extended telehealth rules for providing lifelines to rural and underserved populations in particular, prompting some to propose bills last year to make the changes permanent.
Related: Providers see hospital-at-home growth potential in cancer care
Key House members, however, are not sure how a new extension will be enacted, even as they say it must be, along with items such as community health center funding.
"Those are all things that have been really good things," House Appropriations Committee Chair Tom Cole (R-Oka.) said Tuesday. "We save a lot of money with telehealth. We save a lot of money with community health centers."
But Congress is dealing with multiple, contentious priorities that are complicating the path forward for telehealth, including passing legislation to extend expiring tax cuts, agreeing on federal appropriations for the rest of the fiscal year and raising the debt limit.
Government funding expires March 14 under a short-term measure Congress and President Joe Biden enacted in December. That legislation extended telehealth rules and other healthcare programs until the end of March.
Cole is "not sure at all" that Congress will meet the March 14 funding deadline, or get the health extenders done by March 31, he said. "I'd say we're still stumbling through the dark, but we're moving in the right direction."
If they cannot pass legislation in time, another stopgap bill known as a continuing resolution or CR, may be needed, although the legislators did not address that.
Some lawmakers tried to permanently extend telehealth authorities last year, but cost concerns prompted the House Energy and Commerce Committee and the House Ways and Means Committee to advance five-year extensions. Those were whittled down to just a few months when Congress' attempts to pass a larger government funding bill failed in December.
Others who advocate for a telehealth extension were not much more certain than Cole, whose committee is responsible for spending bills such as fiscal 2025 appropriations and CRs.
Energy and Commerce Committee Chair Brett Guthrie (R-Ky.) said Tuesday that telehealth authorities must continue. "We're still working on the right place for all that," he said. "We haven't got the pathway forward yet, but I know there's going to be a pathway forward."
Similarly, Rep. Dr. Greg Murphy (R-N.C.), a member of the Ways and Means Committee, said he is resolved to keep the current rules in place by attaching an extension to whatever will pass in time.
"We will have vehicles that pop up. This is what happens in Congress all the time, so I'm not worried about it," Murphy said. "We will pop it through, and it's going to be critical. That's obviously a big, huge concern of mine. We're dealing here with our CR, so we're going to be able to walk and chew gum."
The American Medical Association estimated in 2023 that about three-quarters of doctors worked in practices that used telehealth, compared to one-quarter before the pandemic. The AMA testified to Congress last year that telehealth flexibilities were vital to reaching rural and underserved populations, as well as driving innovation.
