Senate Showdown May Lead to End of Telehealth Extension

WASHINGTON—A potential government shutdown could mean legislation extending telehealth flexibilities won’t pass in time to ensure continued access after the current waivers end Jan. 30. 

The House passed a bipartisan three-bill FY26 funding package on Jan. 20 that includes several telehealth provisions and also covers Labor, U.S. Department of Health and Human Services (HHS), Education, Defense and Transportation legislation. The bill provides a total of $116.6 billion to the Department of Health and Human Services and maintains funding for rural health, health care workforce and other health programs.

But Democrats are trying to block the package over funding for the Department of Homeland Security, and if the Senate fails to advane a spending measure by 12:01 a.m. Eastern on Saturday, it will trigger a partial U.S. government shutdown. 

The National Alliance for Care at Home (the Alliance) warned members that an agreement is unlikely to pass the Senate, which means telehealth flexibilities will end Jan. 30. 

The bill also includes focus on one-year extensions of the Medicare-dependent hospital and low-volume adjustment programs, a two-year extension of telehealth flexibilities and a one-year delay of payment reductions for clinical laboratory services.

Critical telehealth extensions included in the spending package are:

• Extension of Medicare telehealth flexibilities through Dec. 31, 2027.
• Five-year extension of the Acute Hospital Care at Home Program through Sept. 30, 2030.
• Extension of in-home cardiopulmonary rehabilitation flexibilities through Jan. 1, 2028.
• Enhancements to certain durable medical equipment (DME) requirements under Medicare.
• Requirement that HHS issue guidance within one year on furnishing telehealth services to individuals with limited English proficiency.
• Inclusion of virtual diabetes suppliers in the Medicare Diabetes Prevention Program through Dec. 31, 2029.

ATA Action, the advocacy arm of the American Telehealth Association, said time running out will lead to restricted access to care. 

“If Congress allows expiration of these critical services as part of another government shutdown, it will again cause major disruption, particularly as many patients, healthcare providers and hospital systems have not fully recovered from the October shutdown,” said Alexis Apple, deputy executive director of ATA Action and vice president of public affairs at the ATA. “Our most vulnerable patients who have integrated these models into their ongoing care—including millions of Medicare beneficiaries, individuals in rural areas and those with mobility challenges—would suddenly lose access to virtual care and hospital at home services that have become standard practice. We implore Congress to find a solution to extend these vital services before Friday’s deadline, to ensure continued access to telehealth services for patients and providers without disruption.”

The Alliance said it recommends that home health agencies and hospices prepare for the telehealth flexibilities to end Jan. 30.

“This may mean reviewing all the F2F (face to face) encounter due dates within the hospice F2F encounter timeframe, which is 30 days prior to the third or subsequent benefit period,” the Alliance said. “If the due date falls within the 30 day period after Jan. 30 (March 1) and the hospice wishes to utilize telehealth for the encounter, organizations may want to have it completed no later than Jan. 30.  

“The F2F encounter due date may be more difficult to anticipate in home health,” the Alliance continued. “However, if an agency is aware that an encounter will be needed prior to the home health encounter timeframe—90 days before or 30 days after the start of care—and the physician/allowed practitioner intends to utilize telehealth to complete the encounter, the agency may want to ensure the physician/allowed practitioner and patient are aware of the expiration date of telehealth flexibilities so they can plan accordingly.”