Health care providers across the country are canceling telehealth visits with Medicare beneficiaries or warning patients they will have to pay out of pocket for appointments because Congress let coverage lapse.<\/p>\n
When government funding expired Sept. 30, so did several health care policies mostly involving payments, and among them are provisions that allowed Medicare to cover telehealth services for millions of people who are 65 and older or have disabilities.<\/p>\n
Congress typically extends this telehealth coverage before it expires, but the provision became a casualty in the broader impasse on funding the government.<\/p>\n
\u201cIt\u2019s already leading to widespread disruptions and it\u2019s something that need not have happened,\u201d said Kyle Zebley, executive director of American Telemedicine Association Action, which advocates for permanent Medicare telehealth coverage. \u201cPatients desperate to stay out of in-person settings out of absolute necessity are now being told for no reason other than lack of congressional action now they\u2019re out on their own.\u201d<\/p>\n
Before 2020, Medicare\u2019s coverage of telehealth services was very limited, mostly to people living in rural communities. Those people still had to travel to a provider\u2019s office to do a telehealth appointment with another provider.<\/p>\n
But the pandemic changed the landscape. Restrictions on access for beneficiaries in traditional Medicare \u2014 also called fee-for-service \u2014 were removed during the first Trump administration, allowing people to have appointments from home. Telehealth use has since increased significantly among Medicare beneficiaries. In the first quarter of this year, 15 percent of traditional Medicare beneficiaries had a telehealth service, according to the Centers for Medicare and Medicaid Services.<\/p>\n
Congress then allowed those flexibilities to continue after the COVID-19 public health emergency.<\/p>\n
While Medicare telehealth coverage enjoys bipartisan support in Congress, lawmakers have only temporarily extended it \u2014 mostly due to concerns about cost. Beneficiaries can still use telehealth for behavioral health services because Congress made that coverage permanent in 2021.<\/p>\n
But the lapse for other telehealth services is especially impacting people with disabilities, who are more likely to use such coverage, according to CMS data.<\/p>\n
Of people who are eligible for Medicare because of disability, nearly 30 percent received a telehealth service in the first quarter of 2025, according to CMS. That compares to about 11 percent of Medicare beneficiaries who are eligible for Medicare because they are over 65.<\/p>\n
One is Northern California resident Charis Hill, 38, who was told Tuesday by their rheumatologist\u2019s office that an Oct. 7 telehealth appointment would not be covered by Medicare. Hill, who has a telehealth appointment every three to four months for ankylosing spondylitis, a type of chronic inflammatory disease, was advised they could book an in-person appointment. But Hill is immunocompromised.<\/p>\n
\u201cI said I can\u2019t do that. It\u2019s not safe for me to do that without masks in the office. What are my options?\u201d Hill said. \u201cI was basically told, \u2018You need to contact Medicare.\u2019\u201d<\/p>\n
Hill is exploring other options, including whether their Medicaid coverage could defray the cost.<\/p>\n
The rheumatologist can still prescribe Hill\u2019s medications, but Hill doesn\u2019t know how long that will last.<\/p>\n
\u201cI am worried that if I can\u2019t find a solution that will allow me to continue getting care via telehealth I\u2019ll lose access to my specialist, and then lose access to medications and treatment that slow the progression\u201d of the illness, Hill said. \u201cThis disproportionately impacts disabled people who have been fighting for years to have equitable access to health care. Telehealth has improved lives for millions of people, especially people who have become disabled by long COVID.\u201d<\/p>\n
Provider uncertainty<\/p>\n
The lapse also poses challenges for health care providers, who must decide whether to continue offering telehealth services with no guarantee they will be reimbursed by Medicare.<\/p>\n
\u201cThere\u2019s an expectation that Congress will provide a retroactive fix, but there\u2019s obviously no guarantee that will happen,\u201d said Jeffrey Davis, a director at health policy consultant McDermott+, where he focuses on Medicare policy.<\/p>\n
Providing coverage as though nothing has changed isn\u2019t a risk every provider can take, Davis notes. Those not well-steeped in the latest from Washington saw that telehealth coverage expired on Oct. 1 and have stopped offering those services to Medicare beneficiaries. CMS is telling providers they can offer the services, but should inform patients Medicare may not pay for them.<\/p>\n
\u201cFolks are confused,\u201d Davis said.<\/p>\n
A bill, sponsored by Sen. Brian Schatz, D-Hawaii, has 65 co-sponsors \u2014 enough support to pass the Senate if it were to receive a vote today.<\/p>\n
But the projected cost \u2014 $25 billion over 10 years \u2014 has been a roadblock for a Congress that typically demands that health care spending be offset.<\/p>\n
The House-passed short-term government funding bill that the Senate has been voting on this week would extend Medicare telehealth coverage for the length of the continuing resolution \u2014 about seven weeks. But the bill hasn\u2019t gotten enough support to pass the Senate. Democrats are demanding the bill extend expiring health care subsidies that help people buy insurance in the individual market.<\/p>\n
Zebley said he hopes the chaos caused by this lapse will push Congress to make Medicare telehealth coverage permanent.<\/p>\n
\u201cI\u2019m hopeful this will be an opportunity to work with President Trump and Congress and use this as a rallying cry for why we need permanence,\u201d Zebley said.<\/p>\n","protected":false},"excerpt":{"rendered":"Health care providers across the country are canceling telehealth visits with Medicare beneficiaries or warning patients they will…\n","protected":false},"author":3,"featured_media":279438,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[108048,29658,8015,49087,276,50049,36730,327,117152,7824,7033,25982,26621,210,1141,1142,17819,7337,3170,3235,153,16854,277,67,132,68,333,2058],"class_list":{"0":"post-279437","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-108048","9":"tag-29658","10":"tag-american","11":"tag-brian-schatz","12":"tag-california","13":"tag-casualty","14":"tag-centers-for-medicare-and-medicaid-services","15":"tag-congress","16":"tag-continuing-resolution","17":"tag-coronavirus","18":"tag-democrats","19":"tag-executive-branch","20":"tag-hawaii","21":"tag-health","22":"tag-health-care","23":"tag-healthcare","24":"tag-house","25":"tag-insurance","26":"tag-medicaid","27":"tag-medicare","28":"tag-policy","29":"tag-senate","30":"tag-trump","31":"tag-united-states","32":"tag-unitedstates","33":"tag-us","34":"tag-voting","35":"tag-washington"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/115321448876975801","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/279437","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=279437"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/279437\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/279438"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=279437"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=279437"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=279437"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}