House Panel Throws Unanimous Support Behind Telehealth Bill

WASHINGTON — The House Ways and Means Committee unanimously advanced a bill on Wednesday that would extend Medicare’s COVID-era ability to support telehealth visits and pay for acute-level hospital care provided in patients’ homes.

The proposed legislation, called the Preserving Telehealth, Hospital and Ambulance Access Act, was introduced by Rep. David Schweikert, R-Ariz., a longtime advocate for telehealth services.

It passed by a 31-0 vote after lawmakers on both sides of the aisle talked through their reservations about a handful of issues, including hospice recertification.

With Wednesday’s action, the bill now appears certain to be considered by the full House later this year.

Schweikert’s proposal would extend the Centers for Medicare & Medicaid Services flexibilities related to telehealth through 2026.

Among other things, the bill extends care providers’ ability to recertify patients for hospice care, though there are a few exceptions — if, for instance, a hospice is undergoing a period of enhanced oversight by the agency, it would not be able to recertify via telehealth.

The bill would also extend the Centers for Medicare & Medicaid Services’ Hospital at Home waiver program, which allows enrolled hospitals to receive payment for acute-level hospital care provided at home, for an additional five years.

While some lawmakers expressed concern about possible fraud or abuse being perpetrated through the program — mainly through the purchase of high-cost durable medical equipment and diagnostic tests through the program — others said they were confident appropriate guardrails were in place.

And of the latter group, several members suggested that perhaps the telehealth program should be extended permanently.

“I’m of the view that telehealth ought to be, perhaps, a permanent part of Medicare, but recognize the merit to additional study and consideration of telehealth utilization and, specifically, guardrails,” Rep. Mike Thompson, D-Calif., said at one point during the morning hearing.

“We have an obligation to be responsible stewards of taxpayer dollars, and there are ways this committee can work to ensure that Medicare pays for telehealth in high-value settings, avoids unnecessary utilization and has robust anti-fraud and anti-abuse measures in place,” he said.

During the coronavirus pandemic, the Centers for Medicare & Medicaid Services allowed hospices to perform routine home care visits virtually, as well as conduct face-to-face recertification visits. 

Congress later extended that flexibility through Dec. 31, 2024. Wednesday’s markup of the extension was only one item on the Ways and Means Committee’s crowded agenda this morning.

Other bills advanced on Wednesday included:

• The Preserving Emergency Access in Key Sites Act of 2024, which expands emergency services for patients served by Critical Access Hospitals.
• The Rural Hospital Stabilization Act, which provides resources to help struggling hospitals continue to serve patients in rural and underserved communities.
• The Ensuring Seniors’ Access to Quality Care Act that allows more nursing homes to continue training nurses and serving patients.
• The Rural Physician Workforce Preservation Act, which target’s rural America’s doctor shortage by shutting a loophole that has resulted in residency slots meant for rural training programs being taken by urban hospitals.
• The Second Chances for Rural Hospitals Act to expand the designation for Rural Emergency Hospitals to give rural communities a second chance at access to emergency and outpatient services.

Among those who applauded the passage of the bills, was Rep. Greg Murphy, R-N.C., a member of the committee and the only practicing surgeon in Congress.

“Protecting high-quality, accessible and affordable health care for rural communities is one of my top priorities,” Murphy said in a written statement. 

“As a physician of over 35 years, serving 29 counties in Eastern North Carolina, I uniquely understand the challenges rural America faces in accessing care,” he said. “We must address the critical physician workforce shortage our non-metro communities experience and preserve the opportunity for all patients to utilize telehealth services. 

“It is well known that if a medical student comes from, or a resident rotates into, a rural area, they will be much more inclined to come practice there after their studies,” he added.

Dan can be reached at [email protected] and @DanMcCue