Telehealth flexibilities at risk of expiring as federal government shutdown approaches

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Telehealth advocates are watching the clock, Congress and the White House to see what effects a government shutdown could have on providing and receiving medicine by computer and phone.

The administration of President Donald J. Trump largely earned praise for flexibilities and rule changes that allowed for expanded use of telemedicine during the COVID-19 pandemic. The administration of President Joe Biden and Congress largely continued those allowances.

But some of those flexibilities are scheduled to expire Sept. 30, and it was unclear how telemedicine rules might fit into legislation that would avoid a government shutdown.

“We are asking – urging – Congress to not leave millions of patients and beleaguered health care providers dangling on the telehealth cliff while they deliberate over dynamics around a government shutdown,” ATA Action Executive Director Kyle Zebley said in a statement last week. Zebley also is senior vice president, public policy at the ATA.

In September, the American Telemedicine Association’s advocacy group, ATA Action, requested additional time for the public health provisions involving telehealth — or to make them permanent for Medicare policy. ATA Action focused on those in its comment on the 2026 Medicare Physician Fee Schedule proposed by the U.S. Centers for Medicare & Medicaid Services.

Congress extended the following flexibilities through Sept. 30:

• Waiving originating and geographic sites
• Audio-only coverage
• Expansion of Medicare telehealth list to include therapists
• Allowing Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to serve as distant sites
• Temporary waiver of telemental health in-person requirement
• Continuation of Acute Hospital Care at Home Program

The 2026 MPFS does not address those programs, but it needs to, according to ATA Action.

In the event of a shutdown, ATA wants Congress to include a retroactive statement that ensures reimbursement for telemedicine services provided during a shutdown.

“We should at least give providers some reassurance that they will receive back payment for essential health care services delivered during this shutdown,” Zebley said. “And give their patients piece of mind that their access to needed care will not be pulled out from under them.”

More changes proposed

In its comments on the 2026 Medicare Physician Fee Schedule, ATA Action suggested positive action on a number of other provisions of the 2026 MPFS:

• Facilitate diagnostic testing by virtual care providers
• Finalize proposed modification of the Medicare telehealth services list and review process
• Clarify, finalize, and extend the Medicare Diabetes Prevention Program (MDPP)
• Expand the Advanced Primary Care Management (APCM) codeset to all providers
• Expand digital mental health treatment code proposals and codes
• Expand coverage for digital therapeutics with new codes
• Create separate coding and payment for medically tailored meals

Endorsing legislation

Congress is considering at least three bills that could have effects on telehealth.

ATA Action announced it has endorsed the Telehealth Modernization Act that would extend telehealth flexibilities through fiscal year 2027. Bipartisan companion versions have been introduced in the House of Representatives and the Senate.

ATA Action announced it also has endorsed:

• The Hospital Inpatient Services Modernization Act, which would extend the Acute Hospital Care at Home Program through 2030. More than 300 hospitals in 37 states participate in the program.
• The Ensuring Patient Access to Critical Breakthrough Products Act, which would guarantee four years of Medicare coverage for items designated as breakthrough technologies by the U.S. Food and Drug Administration.

Both of those bills have been approved by the House Ways & Means Committee.