One silver lining of the COVID-19 public health emergency (PHE) has been the rapid expansion of telehealth. Congress is still figuring out exactly which flexibilities to expand beyond the COVID-19 PHE and how to move forward with future telehealth policy. The COVID-19 PHE was just extended for another 90 days on July 15^th and the FY2022 Omnibus Appropriations bill extended existing telehealth flexibilities for 151 days post PHE. Last week, H.R. 4040 passed the House of Representatives. The bill proposes to replace the FY2022 omnibus language regarding extending telehealth flexibilities for “151 days post PHE” with an extension until December 31, 2024 (if the PHE ends before that date).

The bill provides the following extensions:

• Remove geographic restrictions and expand originating sites for telehealth services, that allow the originating site to be any site in the United States which an eligible beneficiary is located. Including the home of the individual, without geographic restrictions;
• Allow virtual certification of hospice face-to-face recertification during the emergency period;
• Allow the continuation of coverage and payment of telehealth services furnished using audio-only telecommunications technology;
• Delay the in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology;
• Extend telehealth services for Federally Qualified Health Centers and Rural Health Clinics; and
• Expanding the practitioners eligible to furnish telehealth services, to include qualified physical therapists, occupational therapists, speech-language pathologists, and audiologists.

Hospices should remember that the bill does not impact the routine home care flexibility. CMS allowed hospices to utilize telehealth for routine home care visits during the PHE. CMS will need to establish a policy on the utilization of telecommunications, both video and audio only, post PHE with regards to routine home care.

Additionally, the bill does not extend all Part B codes. While the bill does extend the ability of allowing beneficiaries to access telehealth services from wherever they call home, CMS has a list of services that are eligible for billing when done via telehealth – some of them have been extended through 2023, some are permanently eligible for telehealth coverage, and some are only extended through the public health emergency. CMS has the authority to make changes to the codes that are eligible to be billed when the service is provided via telehealth. We will advocate to them to continue allowing codes used for Part B palliative care and other relevant services provided by LeadingAge to be billable when done via telehealth after the PHE as appropriate.