Telehealth on hold: Did this happen because of the federal government shutdown?

Telehealth flexibilities for payment in Medicare fee-for-service expired at the same time the federal government shut down due to lack of an agreed budget bill. However, it would be a mistake to assume one caused the other. Kyle Zebley is senior vice president, public policy, of the American Telemedicine Association, and executive director of ATA Action, its advocacy affiliate. Here he explains the timing, the distinction between two issues that technically remain separate in Washington, D.C., and why telehealth advocates have become victims of circumstance.

Medical Economics: Given the timing that we're talking about, even right now, strictly speaking, is the expiration of the telehealth flexibilities directly tied to the federal government shutdown, or could one happen without the other?

Kyle Zebley: One could happen without the other, and it's an important distinction. Congress must authorize these extensions of the telehealth flexibilities and the Acute Hospital Care at Home program. They need to proactively do so through a policy language included in a piece of legislation. It could exist outside of any government spending bill. And so you could have a situation where we would have been extended and the government still shut down, or vice versa. You could have had a situation where we were left out and the government still was funded, and there was no shutdown. The reason why we're in the position that we are, where our kind of telehealth flexibilities and Acute Hospital Care at Home shutdown has occurred at the same time as our government spending shutdown, it's because Congress really ends up, in a given year, only passing a small number of bills. They must do a few things over the course of the year, raise debt ceiling periodically, and, of course, keep the government funded and therefore popular bipartisan items that are broadly supported, that the Congress wants to keep in place and make sure it doesn't expire, oftentimes, as I would frame it, hitch a ride on a must-move piece of legislation. Mostly that has meant that we're pitching a ride on government funding bills. That's served us well so far in terms of making sure these flexibilities don't go away. Unfortunately, again, we were a victim of circumstance, caught up in this drama. And again, it's very frustrating, because nobody's out to get us, nobody's opposed to us, everybody's on the record in support of us, and yet we still got caught up in these unfortunate dynamics.