The telehealth crisis of 2025, with Kyle Zebley, senior VP of public policy at the American Telemedicine Association

Kyle Zebley, senior vice president of the American Telemedicine Association (ATA) and executive director of ATA Action, joins the show to talk about what happened when Medicare’s telehealth flexibilities expired at the start of the October 2025 federal government shutdown.

In discussion with Medical Economics Senior Editor Richard Payerchin on October 3, 2025, Zebley explains how the lapse has disrupted care for patients and physicians nationwide, what Congress can do to fix it and why making telehealth permanent remains one of the most urgent priorities in U.S. health policy.

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Music Credits:
RELAXED CHILL JAZZ LOUNGE (OVER THE RIVER) by Tasty Tunes - stock.adobe.com
Relaxing Lounge by Classy Call me Man - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

0:00 – 1:42 | Introduction
Austin Littrell introduces the episode, summarizing the telehealth lapse following the federal government shutdown and previewing the interview with Kyle Zebley.

1:42 – 2:32 | Setting the stage
Host Richard Payerchin introduces Kyle Zebley. Zebley opens with a description of the “sad, desperate state” of telehealth following the October 1 shutdown.

2:32 – 4:09 | How the lapse happened
Zebley explains the simultaneous expiration of pandemic-era telehealth flexibilities and the government shutdown — calling it a “victim of circumstance.”

4:09 – 6:34 | How telehealth evolved since COVID-19
Discussion of how the COVID-19 pandemic transformed telehealth and accelerated its adoption across Medicare and private insurance.

6:34 – 8:06 | The scope of telehealth today
Zebley outlines usage statistics: about one in four Medicare beneficiaries now use telehealth, accounting for roughly 13% of all visits.

8:06 – 10:15 | Shutdown vs. policy lapse
Clarifying that telehealth’s expiration isn’t automatically tied to the government shutdown — Congress must act to reauthorize.

10:15 – 12:30 | Why permanence matters
Why ATA advocates for making telehealth flexibilities permanent; the legislative gridlock preventing it.

12:30 – 14:07 | Will retroactive reimbursement happen?
Zebley predicts retroactive payments are likely but not guaranteed — urging continued advocacy.

14:07 – 14:21 | Patient Care Online plug
Quick mention of sister site PatientCareOnline.com for additional clinical information.

14:21 – 16:20 | Advice for medical practices
Guidance for physicians weighing whether to continue virtual visits during the lapse; balancing financial risk with patient needs.

16:20 – 18:45 | Impact on private insurance
Zebley notes no major changes among private insurers — but Medicare sets the “floor” for telehealth expectations.

18:45 – 20:40 | Bipartisan support in Congress
Discussion of political dynamics; Zebley praises continued bipartisan support for telehealth under both Trump and Biden administrations.

20:40 – 24:18 | Mental health coverage and the in-person requirement
Explains permanent coverage for telemental health but criticizes the “clinically inappropriate” in-person requirement as a barrier.

24:18 – 25:09 | P2 Management Minute
Interlude with Keith Reynolds sharing practice management tips and inviting audience participation.

25:09 – 25:54 | The Acute Hospital Care at Home program
Zebley discusses why the program is vital for expanding capacity and patient satisfaction — and how the shutdown halted it.

25:54 – 28:47 | Rural health clinics and FQHCs
Why distant-site telehealth flexibilities are critical for rural and underserved communities.

28:47 – 30:30 | How to advocate for telehealth
Zebley explains ATA’s grassroots advocacy tool that connects citizens with Congress to restore telehealth and hospital-at-home programs.

30:30 – 32:31 | What physicians can do now
Calls on physicians to use their credibility to pressure lawmakers: “Stop the insanity and bring back these programs.”

33:53 – 35:12 | Closing remarks
Richard Payerchin closes the interview; Austin Littrell wraps up the episode and reminds listeners to subscribe and visit MedicalEconomics.com and PhysiciansPractice.com.

35:12 – 35:40 | Credits