House committee passes telehealth flexibility extension

Dive Brief:

• A House committee voted Wednesday to advance a bill that would extend telehealth flexibilities in Medicare for another two years. 
• The legislation, called the Telehealth Modernization Act of 2024, passed unanimously in the House Committee on Energy and Commerce, sending the bill to the House floor to await consideration.
• The bill would avert a year-end expiration of the pandemic-era flexibilities. Telehealth advocates say time is running out to extend the pandemic changes, potentially disrupting access for patients who have come to rely on virtual care.

Dive Insight:

The committee showed bipartisan support for extending the flexibilities, which were put in place to preserve healthcare access during the COVID-19 pandemic. Legislators argued virtual care continues to help patients receive critical services, especially in underserved communities. 

“Telehealth has proven to be a safe, effective way to deliver care,” said Rep. Buddy Carter, R-Ga., a sponsor of the legislation. “It's a lifeline for patients in rural areas and those with mobility issues.”

The bill would extend flexibilities that expand the types of practitioners eligible to offer telehealth services and allow Medicare beneficiaries to receive virtual care in their homes and through audio-only calls until the end of 2026, among other changes. 

It would also continue a program that allows certain hospitals to offer inpatient-level care in patients’ homes through 2029. 

The legislation is funded through transparency requirements and payment reforms for pharmacy benefit managers, a hot topic for lawmakers who argue the middlemen in the pharmaceutical supply chain contribute to rising drug costs. 

The bill comes as the clock is ticking to pass an extension to telehealth flexibilities before they expire at the end of year. Telehealth providers have argued it’s challenging to operate their programs when policy — and reimbursement — is in flux. 

The future of other pandemic-era telehealth flexibilities is uncertain too. Federal regulators allowed clinicians to prescribe some controlled substances, like treatments for opioid use disorder or stimulants for ADHD, without an in-person evaluation during the public health emergency.

Those flexibilities have been extended twice, but they’re also set to expire at the end of the year. In August, Politico Pro reported the Drug Enforcement Administration was planning to propose significant restrictions to telehealth prescribing, citing a former agency official familiar with the proposal.

Telehealth groups and providers last week pushed Congress and the Biden administration to extend the prescribing flexibilities, worried the window is rapidly closing for regulators to propose a rule. 

Multiple representatives at Wednesday’s hearing agreed the prescribing flexibilities were critical, arguing patients could be cut off from pain medications, drugs for ADHD or treatments for substance use disorder.

Rep. Ann Kuster, D-N.H., said the delay was especially worrying, given the nation may be finally starting to see a decline in drug overdose deaths. Some research has found expanded telehealth services could reduce the likelihood of medically treated and fatal opioid overdoses and helped Medicaid beneficiaries stay in treatment. 

“It’s nonsensical for the DEA to pull out the chair from under those on the road to recovery,” she said. “The DEA should stop standing in the way of people getting the medicine they desperately need.”