Health Law Highlights

Telehealth and the Evolving Landscape of Medicare Requirements

From Verrill, by Amanda Beauregard, Andrew Ferrer:

Telehealth Importance and Changes Post-Pandemic: Telehealth has been crucial during the COVID-19 pandemic, especially for behavioral and mental health services. The U.S. Department of Health & Human Services (HHS) facilitated its expanded use by easing Medicare regulations. Key changes included recognizing a patient’s home as an “originating site” and allowing telehealth without an initial or periodic in-person visit. However, with the end of the Public Health Emergency (PHE), Medicare rules for telehealth services are changing.

Permanent Telehealth Flexibilities: Some telehealth flexibilities will remain post-PHE, including Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) serving as “distant site” providers for behavioral/mental telehealth services, no geographic restrictions for these services, and the allowance of audio-only communication platforms. 

Temporary Telehealth Flexibilities: Many telehealth flexibilities are set to expire after December 31, 202These include FQHCs and RHCs serving as a distant site provider for non-behavioral/mental telehealth services, no geographic restrictions for an “originating site” for non-behavioral/mental telehealth services, and using audio-only communication platforms for non-behavioral/mental telehealth services.

Advocacy Efforts for Permanent Telehealth Flexibilities: Several trade associations and lawmakers are advocating for making all Medicare telehealth flexibilities permanent. They aim to ensure equitable payment for FQHCs and RHCs, remove geographic and “originating site” restrictions, eliminate the periodic “in-person” rules, maintain coverage for audio-only treatment, and expand the list of eligible Medicare providers.

Legislation Introduced for Telehealth: Several bills have been introduced to further these goals, including the CONNECT for Health Act, Telemental Health Care Access Act, Telehealth Expansion Act, Telehealth Benefit Expansion for Workers Act of 2023, and TREATS Act. These proposed laws aim to remove geographic requirements, add homes as “originating sites,” remove in-person evaluation requirements, and extend exemptions for telehealth services, among other things.