President Biden Signs Consolidated Appropriations Act of 2022, Extending Medicare Coverage of Telehealth

Q. During COVID, my parents took advantage of telehealth for primary care, neurology, and mental health appointments, and it was covered by Medicare. It was so much easier for them to attend their doctor’s appointments remotely, as neither of them is able to drive at this time. We’re hoping that telehealth will continue to be covered, so they can keep taking advantage of it. I think I heard something about a recent law that extends Medicare’s telehealth coverage until the end of the year? Can you provide more information on this? Thanks for your help!

A. For many Medicare enrollees, telehealth was critical for providing services during the first year of the COVID-19 pandemic and it continues to be today. In fact, over 28 million Medicare beneficiaries (two out of five) used telehealth in 2020-21.

Seniors’ use of telehealth services demonstrated the long-term potential of telehealth to increase access to health care. Medicare beneficiaries also benefited from the ability to utilize telehealth for certain services, such as mental health services.

Last month, on March 15, 2022, President Biden signed into law the $1.5 trillion omnibus spending bill called the Consolidated Appropriations Act of 2022. The law includes an extension of Medicare coverage of professional consultations, office visits, and office psychiatry services conducted via telemedicine for 151 days after the end of the pandemic (designated as a public health emergency). The provision temporarily allows high-deductible health plans to provide telemedicine services without a deductible from April 1, 2022, through December 31, 2022. This provision was originally enacted as part of the CARES Act but expired on December 31, 2021.

The new law also includes the following:

• Removes geographic requirements for telehealth services.
• Expands practitioners eligible to offer telehealth services.
• Extends telehealth services for Federally Qualified Health Centers and rural health clinics.
• Delays the in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology.
• Allows for audio-only telehealth services.
• Extends the flexibility allowing a high-deductible health plan to cover telehealth benefit (for months beginning after March 31, 2022, through the end of 2022) pre-deductible and still qualify as a high-deductible health plan with a Health Savings Account.

Prior to the pandemic, in order to qualify for Medicare coverage:

• A patient receiving telehealth services had to be physically located at a physician’s office, hospital, or other health care facility that is located in a geographical health professional shortage area that met certain requirements, a county that was not included in a Metropolitan Statistical Area as of December 31 of the preceding year, or an entity participating in a federal telemedicine demonstration project in order for telehealth services to be covered by Medicare.
• The patient had to obtain telehealth services furnished through technology that enabled real-time audiovisual communication, with limited recent exceptions.
• Medicare covered telehealth services only if offered by physicians, physician assistants, nurse practitioners, clinical nurse specialists, nurse-midwives, clinical psychologists, clinical social workers, registered dieticians, or certified registered nurse anesthetists.

Administrative and legislative changes made in March 2020 as part of the government’s response to the COVID-19 pandemic waived these location and technology requirements. These waivers of location and technology requirements are now extended further under the law.

Under the new law, qualifying practitioners now also include occupational therapists, physical therapists, speech-language pathologists, and audiologists. Other changes include delaying in-person requirements for the provision of mental health services.

Congress and State Governments Are in Favor of Making Some Aspects of the COVID-19 Telehealth Policy Permanent

Providers, especially physicians, are advocating for full permanent Medicare reimbursement for telehealth. Congress is considering making some aspects of the COVID-19 Telehealth Policy permanent because during the pandemic, research shows that telehealth can save money. The Congressional Budget Office (CBO) and the Medicare Payment Advisory Commission, an independent congressional agency, also assume that utilization of telehealth will grow substantially.

Experts Endorse Expanded Coverage of Telehealth

During a press event, HHS Secretary Becerra stated a fairly broad endorsement of telehealth. He was quoted as stating, “(w)e would be really closing our eyes to a new form of quality health care if we did not expand authorities for telehealth to be available to Americans.” The American Association of Medical Colleges also applauded the telehealth provisions in the legislation, noting that “temporarily extending these telehealth waivers at the end of the public health emergency will provide policymakers with time to partner with stakeholders to make telehealth access permanent for patients, families, and communities, especially those in rural, urban, and other underserved areas.”

The New Law Also Affects Veterans

The new law also provides funding for the Department of Veterans Affairs (the VA) including $882 million for the VA Medical and Prosthetic Research program in FY 2022. For VA Community Care, the bill provides an additional investment of $3.3 billion in FY 2022 funding, on top of the $20.15 billion provided in the prior year’s appropriation, for a total $4.9 billion (26.5%) increase in FY 2022 over the comparable FY 2021 spending level.

We will continue to monitor legislative and regulatory changes impacting telehealth for seniors.

Plan for Your Future and Your Loved Ones Today!

Laws are continuously changing when it comes to Medicare and what is covered. One thing that’s not likely to ever change is that Medicare does not cover long-term care. For anyone who does not have their planning in place, now is an ideal time to do so when it comes to Medicaid planning, estate planning, or special needs planning. Here at the Farr Law Firm, we have strategies to help everyone plan for themselves and their loved ones. With advance planning, each person can retain the income and assets it has taken a lifetime to accumulate and provide themselves the peace of mind that they are prepared should something happen to them or a loved one.

When you’re ready to plan, contact us for an initial consultation:

Elder Care Law Fairfax: 703-691-1888
Elder Care Law Fredericksburg: 540-479-1435
Elder Care Law Rockville: 301-519-8041
Elder Care Law DC: 202-587-2797