This overview is excerpted from Manatt on Health, Manatt’s subscription service that provides in-depth insights and analysis focused on the legal, policy and market developments. For more information on how to subscribe to Manatt on Health, please reach out to Barret Jefferds.
On May 8, the House Committee on Ways and Means (W&M) held a markup to consider six health-related bills. All of the bills were reported favorably out of the committee. Consideration of the Preserving Telehealth, Hospital, and Ambulance Access Act (H.R. 8261) dominated the discussion at the markup and was advanced unanimously. The legislation provides for several extensions of pandemic-era flexibilities. Specifically, the legislation:
- Extends for two years the Medicare telehealth policies beyond the current expiration date of December 31, 2024. This includes the following flexibilities:
- Any site in the United States, including a patient’s home, can be considered an eligible originating site for the delivery of telehealth services;
- Eligible telehealth practitioners will continue to include qualified occupational therapists, physical therapists, speech-language therapists, and audiologists;
- Federally qualified health centers and rural health clinics may serve as originating or distant sites for the delivery of telehealth services for both behavioral health and non-mental health services;
- Coverage of telehealth services delivered via audio-only format will continue for specific service codes identified by Medicare as being eligible for delivery via audio only; and
- Practitioners will be able to use telehealth to conduct face-to-face encounters for recertification of eligibility for hospice care. However, the legislation limits this option if the individual is located in an area with a moratorium on the enrollment of hospice programs or if the hospice provider is subject to enhanced oversight.1
- Implements new program integrity measures, including:
- Requiring formal guidance on best practices for administering telehealth to individuals with limited English proficiency; and
- Establishing a modifier for billing recertifications of hospice care eligibility conducted through telehealth.
- Extends the Acute Hospital Care at Home waiver flexibilities for five years (through 2029). This program allows hospitals to waive certain Medicare conditions of participation that require patients to be treated on hospital premises in order to receive reimbursement and permits patients to be transferred to their homes.
- Extends hospital add-on payments for Medicare Dependent Hospitals and Low Volume Hospitals for an additional year (through 2025).
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1 These new policies seek to address members’ concerns with hospice fraud.