In the final days of 2022, U.S. President Joe Biden signed into law a bill with major consequences for healthcare providers, and especially those organizations that have shifted to remote and virtual care during the pandemic. Among other impactful features, the omnibus bill extends for another two years telehealth waivers offered from the Centers for Medicare & Medicaid Services (CMS).
The CMS telehealth waivers were originally set to expire with the Covid-19 public health emergency (PHE). The end date of the PHE is currently set at April 11th , after being extended on January 11th by the Department of Health and Human Services (HHS). The president has stated that he will not let the PHE expire without a 60-day advance notice, which now may be expected on February 10th.
Similarly, the passage of the omnibus bill also extends the Acute Hospital Care at Home program through December 31, 2024. In addition, the legislation charges the HHS with analyzing the results of the at-home program and comparing them with “traditional inpatient care delivery and publish a report demonstrating those findings,” in an effort to gauge the financial value of the program on a long-term basis (as reported by the American Hospital Association).
Implemented in November 2020, the Acute Hospital Care at Home program eases restrictions for treating patients needing acute care in their homes or residences, as opposed to a formal care facility. As a result, many organizations have been able to leverage telehealth technology like remote patient monitoring (RPM) to expand their care capabilities.
“As of November 15, at least 256 hospitals in 37 states had applied for and been granted Acute Hospital Care at Home waivers from CMS, although it is not known how many of them are actually providing this care,” writes Larry Beresford at Medscape. “For some, the model has represented a pressure valve for high-occupancy COVID surges.”
In another summary of the bill from HealthLeaders, Eric Wicklund points out that many of those health systems “many had said they would be forced to curtail, drastically change, or even cancel the program once CMS support for the program ends.”
Certainly, the shift to at-home care has had a measurable impact on the industry in recent years, as many companies leverage new funding opportunities and eased restrictions to expand their telehealth offerings, or to seek out the expertise of a third party to help them do so. (As Beresford points out, even established entities like Kaiser Permanente and the Mayo Clinic have partnered with third parties to better deliver at-home care.)
“Before, hospital at home was a series of pilots and a couple of innovation grants from the Centers for Medicare and Medicaid Innovation,” Dr Michael Nassif told Beresford. “But I think we’re now on the cusp of where this could become a permanent program [under Medicare], and then more people will be excited about participating.”
Telehealth waivers extended through December 31, 2024
On top of the extension of the Acute Hospital Care at Home program, the passage of the omnibus bill also extends current CMS telehealth waivers through the end of 2024. Originally set to expire with the PHE — likely to occur in 2023 — the inclusion of the extension has drawn widespread praise from industry groups.
“Today, our Congressional telehealth champions on both sides of the aisle came through for the American people and for ATA and ATA Action members, by meeting our plea for more certainty around telehealth access for the next two years, while we continue to work with policymakers to make telehealth access a permanent part of our healthcare delivery for the future,” said Kyle Zebley of the American Telemedicine Association (ATA) in a public statement.
Specifically, extending the CMS telehealth waivers for another two years means:
- Easing geographic requirements for telehealth services, and expanding the pool of eligible originating sites;
- Waiving Medicare’s in-person requirements for mental health services provided through telecommunications technology;
- Expanding telehealth services available for federally qualified health centers (FQHCs) and rural health clinics (RHCs);
- Adding more providers who are eligible to provide specific telehealth services;
- Allowing for audio-only telehealth services, such as phone calls;
- Allowing for virtual face-to-face encounters “prior to recertification of eligibility for hospice care”
The omnibus bill did not, however, extend a waiver allowing providers to prescribe controlled substances via telehealth, as Wicklund points out.
“Aside from the CMS telehealth waivers, which expanded access to and coverage for telehealth during the COVID-19 Public Health Emergency, the proposed omnibus appropriations bill would also extend by two years safe harbor provisions for telehealth referrals in high deductible health plans (HDHPs) and health savings accounts (HSAs),” he adds.
Both the telehealth waivers and the Acute Hospital Care at Home program “have been essential for hospitals and physicians during the height of the COVID-19 pandemic and the ensuing financial challenges caused by labor shortages, discharge delays and inflation,” writes Susan Morse, Executive Editor of Healthcare Finance.
“Telehealth use soared during the pandemic, with more employees turning to the option and more employers expanding coverage,” writes Kathryn Mayer at the Society for Human Resource Management (SHRM). “SHRM research, for instance, found that 43 percent of organizations expanded telehealth services throughout the COVID-19 pandemic, while 49 percent maintained existing telehealth benefits.”
Leverage the extension of the telehealth waivers by boosting your knowledge of RPM
One of the foundational elements of telehealth and hospital-at-home services, remote patient monitoring has become a core function in care delivery for care providers across the spectrum — from the hospital to home, skilled nursing and senior care, and all points in between.
For a deeper dive into the details of RPM and how it can help your organization expand care under the CMS telehealth waivers, download our Ultimate Guide to Remote Patient Monitoring today.
And if you’re looking for more hands-on data, you can see our RPM solutions in action for yourself by scheduling a free demo.