Ways and Means passes bill to preserve telehealth, hospital at home

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The House Ways and Means Committee has passed telehealth legislation to preserve flexibilities for virtual care introduced during the COVID-19 pandemic.

The Preserving Telehealth, Hospital, and Ambulance Access Act (H.R. 8261), introduced by Rep. David Schweikert, R-Ariz., and Rep. Mike Thompson, D-Calif., expands Medicare telehealth for two years, hospital-at-home flexibilities for five years and Medicare supplemental payments for rural hospitals and ambulance services.

WHY THIS MATTERS

During the pandemic, the Centers for Medicare and Medicaid Services allowed certain flexibilities for the delivery of care. When the public health emergency ended in May 2023, many of these flexibilities ended, but CMS extended the waivers for telehealth, virtual care and hospital care at home through the end of this year.

For these care deliveries to continue, Congress needs to act.

The bill passed by Ways and Means now heads to the full House, and then to the Senate, and to the president for signature before it becomes law. Ways and Means members passed the bill by unanimous vote, which may signal that a measure to extend telehealth and home hospital care use will get House and Senate support.

WHAT THE BILL WOULD DO

The bill proposes to preserve Medicare patients' access to vital telehealth for two years and hospital-at-home services for five years. Twenty-five percent of adults report having utilized telehealth in the past month, and 78% are likely to complete a medical appointment via telehealth again, according to Ways and Means. 

Hospital-at-home is being used by 300 hospitals in 37 states, with 99% of patients being "satisfied" or "very satisfied" with the program.

The bill would also preserve essential Medicare programs that sustain rural and low-volume hospitals that are also scheduled to expire in 2024. Nearly 4.5 million Americans live in counties without an acute care hospital. Rural hospitals have low patient volumes and rely more on federal health programs, contributing to unique care delivery and financial challenges.

The legislation would preserve Medicare add-on payments for urban, rural and super-rural areas to preserve access to crucial emergency ambulance services expiring in 2024. 

Ambulance deserts, defined as areas where access to an ambulance station is more than 25 minutes away, exist in 84% of rural counties and 77% of urban counties.

Ways and Means Committee Chairman Jason Smith, R-Mo., said in his opening statement that 600 rural hospitals are on the brink of closing, people in remote areas sometimes have to wait up to 30 minutes after dialing 911 before an ambulance arrives, small towns are facing a severe shortage of doctors and nurses and patients have to drive hours to routine appointments.

THE LARGER TREND

The Ways and Means Committee approved six bills that address a wide range of healthcare issues, particularly those facing rural communities. 

The package is aimed at helping to prevent rural hospital closures and at expanding the number of doctors and nurses in rural communities.

ON THE RECORD

"In rural America and small towns, families often struggle to get health care," said Ways and Means Committee Chairman Jason Smith, R-Mo. "The lack of access to emergency and outpatient services and preventative care is one of the reasons why rural Americans have a 43% higher mortality rate than urban Americans. Congress has a responsibility to the millions of patients living in rural America to make sure they have access to reliable, quality, lifesaving care."

Email the writer: SMorse@himss.org