Government Shutdown and Medicare Telehealth Lapse

Sarah Hohman, Director of Government Affairs, NARHC

After a failed Senate vote Tuesday evening, Congress has failed to reach an agreement on funding, resulting in a government shutdown as of midnight.

While certain essential or otherwise shutdown-exempt activities will continue, a significant number of employees at CMS and HHS more broadly will be furloughed during the shutdown. While Medicare and Medicaid payments are not impacted, grants, casework, and some federal technical assistance will be disrupted.

We do not know how long this shutdown will last. Health care policy will continue to be a significant component of these negotiations, as Democrats push for an extension of enhanced premium tax credits that will otherwise expire on December 31 as leverage.

Unfortunately, Congress has also failed to extend Medicare telehealth flexibilities. While not a component of federal appropriations, Congress previously aligned the expiration of these flexibilities with the end of the fiscal year and has not since passed legislation to continue them past September 30.

Beginning today, RHCs will no longer receive reimbursement for providing medical Medicare telehealth services to patients located in their homes. With the expiration of originating and geographic flexibilities, patients will only be eligible to receive telehealth services if they are located in a qualifying medical facility (practitioner’s office, hospital, CAH, RHC, FQHC, SNF, or dialysis facility) that is in a rural area or a health professional shortage area.

While RHCs are still permitted to be distant site (billing) providers of telehealth, per CMS authority until December 31, 2025, this can only be done when the patient themselves is in a facility mentioned above, no longer when the patient is in their home.

This is a disappointing lapse in Medicare telehealth flexibilities for both patients and providers who utilize the benefit, particularly given the bipartisan, popular nature of telehealth. This lapse is expected to last in alignment with the length of the government shutdown.

NARHC understands that this will likely raise many questions, and we continue to be here to support you and advocate for you.

For our weekly (and even more frequent these days!) advocacy updates, ensure that you are tapped into our discussion forum here. This is the primary platform NARHC's DC team utilizes for timely and significant updates.

Please email Sarah.Hohman@narhc.org with any questions!