Telehealth Policies in the Omnibus FY 2022 Spending Bill

Health Highlights

After weeks of negotiations and months of temporary stopgap funding bills since the federal fiscal year started in October 2021, on Tuesday the President signed the Consolidated Appropriations Act, 2022, an omnibus funding bill that includes government appropriations for fiscal year (FY) 2022 through September 30, 2022; $13.6 billion in aid for Ukraine; and an array of health policy provisions.1

In addition to discretionary funding for the Department of Health and Human Services (HHS) and other federal agencies, the omnibus legislation includes several health policy provisions, including the following telehealth provisions.

Telehealth Flexibility Extensions Under the Medicare Program.2 The bill temporarily extends the following Medicare telehealth flexibilities, which are central to enabling Medicare beneficiaries’ access to a broad range of services via telehealth from any location, for 151 days beginning on the first day after the end of the public health emergency (PHE) period:3

  • Any site in the United States, including a patient’s home, will be considered an eligible originating site for the delivery of telehealth services.
  • Facility fees will not be paid to newly covered originating sites (e.g., a patient’s home).
  • 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.
  • Providers will not be required to meet in-person visit requirements in order to deliver mental health services via video or audio-only visits. This applies to all sites of care, including Federally Qualified Health Centers and Rural Health Clinics (except in the case of hospice patients).
  • 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.
  • Practitioners will be able to use telehealth to conduct face-to-face encounters prior to recertification of eligibility for hospice care.

Extension of Pre-Deductible Telehealth Coverage for Health Savings Accounts.4 The bill enables health savings account-eligible plans to provide pre-deductible coverage for telehealth services through the end of 2022.

Reports on Telehealth Utilization.5 The bill establishes telehealth reporting requirements for the Medicare Payment Advisory Commission (MedPAC) and the HHS related to telehealth utilization under the Medicare program.

MedPAC will be required to conduct a study on the expansions of Medicare telehealth services in response to the COVID-19 PHE, including extensions made through the omnibus bill, and to deliver a report to Congress no later than June 15, 2023. The study will include an analysis of utilization and payment trends and will evaluate the impact of Medicare’s telehealth policy on access and quality.

The HHS Secretary will be required to post Medicare telehealth claims data, including utilization and beneficiary characteristics, to the Centers for Medicare and Medicaid Services (CMS) website on a quarterly basis, beginning on July 1, 2022. The HHS Inspector General will be required to submit, no later than June 15, 2023, a report to Congress on program integrity risks associated with Medicare telehealth services.

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1 A division-by-division summary of the appropriations provisions is available here.

2 See Division P, Title III, Subtitle A, Sections 301-306.

3 The PHE is set to expire on April 15, but at least one more 90-day extension, through mid-July, is widely expected. For more information about the COVID-19 flexibilities tied to the PHE, see this Manatt on Health analysis.

4 See Division P, Title III, Subtitle A, Section 307.

5 See Division P, Title III, Subtitle A, Section 308.



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