Will Congress upgrade Telehealth? Magic 8-Ball says “Ask again later.”

Physicians, other health care providers and patients love the telehealth expansion that Medicare introduced early in the COVID-19 public health emergency.

But from the earliest days of the expansion there’s been anxiety about when it would all end. Until recently the answer was when the PHE ends. And when this PHE ends is either 90 days after the latest renewal of the PHE. Or the HHS secretary says it ends.

This is not a popular answer because it’s useless to people who just want to schedule patient visits. And it sounds like you’re screwing with their heads. Or high.

Thanks to a provision in the CAA of 2021 the answer is now a slightly-less screwy 151-days after the PHE ends. That isn’t the answer everyone wants, because everyone wants the exceptions to be permanent, but at least an abrupt stop is no longer a threat. (In case you were wondering, there are no telehealth expansion provisions in the IRA.)

And it gives legislators and policy makers more time to figure out whether its possible to loosen telehealth law without triggering an utter and complete shitshow of fraud and sub-standard patient care, and if so, how.

Meanwhile, members of Congress continue to introduce telehealth bills. A lot of bills. So many bills, according to this list maintained by the Alliance for Connected Care. The House recently passed Advancing Telehealth Beyond COVID-19 Act of 2022, which as written it would keep things going until the end of 2024 no matter when the public health emergency ends.

Again, that’s not what people want, and it certainly won’t encourage practices to invest in providing telehealth. But it is far more concrete than “151 days after … some TBD date.” And more importantly, it means Medicare patients can continue to see their doctor without having to go to the office – and sit around with sick people – for every visit.

The bill also sort of keeps the audio-only (a phone call to youse) provisions, but not the one that physicians, nurse practitioners, etc love. That’s the one where Medicare pays roughly as much for a phone call as it does for a face-to-face office visit. However Medicare doesn’t normally cover those telephone encounters at all so if I were a betting woman, I wouldn’t put money on that one sticking around after the PHE. It may be intentional or it could be that this is a result of busy people trying to understand a convoluted mix of law, regulation and temporary measures.

And it could all be irrelevant if it gets stuck in legislative limbo.

You can treat this as an open thread if you wash your hands first.