Piggy bank with dollars around it

The House Wednesday night passed a $1.5 trillion omnibus spending bill that would extend telehealth flexibilities five months after the end of the public health emergency (PHE). 

Such flexibilities include removing geographic requirements and expanding originating sites, which allow patients to receive telehealth services in their own homes and in non-rural parts of the country. The extension also would allow the continuation of audio-only telehealth and for hospices to perform the face-to-face recertification visit via telehealth. The PHE is in place until April 16 but may be extended until the middle of July. 

“We are very pleased to see the extension of the telehealth waivers in the bill as they have proven extremely valuable during the pandemic,” National Association for Home Care & Hospice President William A. Dombi said in a statement. “Our hope is to see these become permanent parts of Medicare in the future. Also, we anticipate further legislative opportunities this year to deal with sequestration as well as our Choose Home bill among other crucial matters.”

Commented Katie Smith Sloan, president and CEO of LeadingAge: “The omnibus’ extension of telehealth waivers for five months after the COVID-19 emergency ends can help to ensure quality of life for millions of older adults who, due to transportation or other issues, rely on virtual visits with their health care providers. Telehealth, as we’ve seen throughout the pandemic, can mean the difference between life and death, particularly for older adults.”

As part of the telehealth provisions, the bill would require reports from both the Medicare Payment Advisory Commission and Office of Inspector General on the expansion of telehealth, as a result of the PHE, to inform future payment and program integrity policy. Also, beginning this July 1, the Centers for Medicare & Medicaid Services would be required to publicly post, on a quarterly basis, data on Medicare claims for telemedicine services, including data on utilization and beneficiary characteristics, according to the bill. 

Another home care measure in the bill would extend until 2031 the current methodology used to update the Medicare hospice aggregate cap. The current methodology is the hospice payment update, which has been in place since 2016, as opposed to the Consumer Price Index for Urban areas (CPI-U).

“A one-year extension is expected to save the government $55 million to $60 million, so when applied across the nearly 5000 Medicare-certified hospices, this provision does not represent a major impact for providers,” NAHC explained. 

One of the main funding items in the bill is a large infusion of aid for war-ravaged Ukraine. Omitted from the 2,700-page bill is President Biden’s $15.6 billion pandemic aid package, after disagreements about its cost threatened to torpedo the legislation.