House reps introduce bills to make telehealth flexibilities permanent

May 03, 2024 - This week, bills to permanently extend several pandemic-era waivers were introduced in the United States House of Representatives.

The first bill would permanently allow federally qualified health centers (FQHCs) and rural health clinics (RHCs) to provide telehealth services. FQHCs and RHCs began receiving reimbursement for telehealth services through the Medicare program during the COVID-19 pandemic. This flexibility is currently set to expire at the end of 2024.

Rep. Greg Murphy, MD (NC-03) first introduced the bill in the House in July 2022, along with Reps. Yvette Herrell (NV-02) and Michael C. Burgess, MD (TX-26).

On April 29, 2024, Murphy and Burgess with Reps. Derrick Van Orden (WI-03) and Troy Nehls (TX-22) reintroduced the bill.

“Rural communities, like those in Wisconsin’s Third District, are routinely left on the sidelines when it comes to accessible health care,” said Van Orden in a press release. “We recently had multiple hospitals in the rural parts of my district shut down with little notice, and now many of my constituents are without nearby medical services. Expanding telehealth access is an important step in bridging the gap between rural and urban communities and helps ensure that folks, no matter where they are, can receive safe, quality care.”

Research shows that telehealth has helped improve healthcare access in rural America. For instance, a study published in 2022 revealed that telehealth increased appointment completion rates in rural areas. For the study, researchers examined data for 110,999 rural patient visits, of which 13,013 occurred through telehealth. They found that telehealth drove appointment completion rates up by about 20 percent.

The second bill, introduced in the House on April 30, would permanently expand the list of healthcare practitioners eligible to provide telehealth services. The expanded list includes physical therapists, occupational therapists, speech-language pathologists, and audiologists. The waiver that expanded the list of eligible telehealth providers expires on December 31, 2024, which would cut off virtual access to various needed services, especially in rural areas.

Reps. Mike Kelly (R-PA), Mike Thompson (D-CA), and Adrian Smith (R-NE), members of the Ways & Means Subcommittee on Health, introduced the bill.

“Americans across the country, especially rural areas, have seen the benefits of telehealth services following the COVID-19 pandemic. Seniors now have the convenience of seeing their doctor from the comfort of their own home. Families with children have new flexibility to work around their busy lives.” said Kelly in a press release. “I am pleased to lead the expansion of these critical services to cover more practitioners who play a vital role in caring for our communities. This bill makes great strides towards delivering modern solutions to our constituents’ future health care needs.”

The bills come at a critical time for telehealth policy. With flexibilities set to expire in just over six months, healthcare stakeholders are calling on Congress to solidify telehealth flexibilities as soon as possible.

In a Februrary letter to Congress, 200 virtual care stakeholders asked for action on telehealth regulations early in the year so that more time could be spent implementing new policies before the waivers expire.

They noted that if Congress takes action soon, it will reassure Medicare beneficiaries, help strengthen the healthcare workforce by allowing for the creation of flexible virtual staffing models, and support continued investment in telehealth tools and infrastructure.

Lawmakers appear to be listening, with a House health subcommittee holding a hearing last month to better understand the ongoing need for telehealth-based care models and the potential pitfalls of expanded access to the care modality.