If Congress does not act before the end of 2024, the CMS is not authorized to continue to cover Medicare’s extended telehealth services beyond the end of this year, except when the patient lives in a “rural area” as specifically defined by statute. No one in the healthcare community or Congress wants to see this happen: 74% of physicians work in a practice offering telehealth, and telehealth services are especially critical in mental health care, which continues to be top of mind for many policymakers. For these reasons, the ACR expects the issue is mainly a matter of hammering out the policy and budget specifics in the very narrow window left before the 118th Congress ends Dec. 31.
Continued access to telehealth services is a priority for the Washington, D.C.-based ACR advocacy team as well as the broader medical community. More legislation has been introduced on this policy topic than any other that we are tracking this Congress; everyone wants a hand in bringing telehealth into the next phase. The hold-up has been the cost to Medicare. The Congressional Budget Office (CBO) scored a two-year extension of the current flexibilities at $2 billion per year, based on estimated increases in the use of Medicare services.
Even with this price tag, Congress is unlikely to let telehealth access expire. However, legislators will likely wait until after the election so none of their political opponents can use the cost of the package (and its “addition to the deficit”) against them in November.
After this likely two-year extension, we hope the CBO will use the additional years of non-COVID data to reassess how much telehealth costs Medicare. We think more data will show telehealth saves the system money, because it has reduced costly emergency room visits and introduced other savings that make it practical permanent policy. A lower CBO score would allow a future Congress to pass a longer extension of the current telehealth flexibilities.
To support extending telehealth flexibilities, visit the ACR’s legislative action center campaign on this topic and send messages to your members of Congress. Such direct communications are particularly important in election years.
