Unwinding of the Public Health Emergency (PHE)

Post-PHE Federal Telehealth policy Landscape becomes More Clear

As we head closer to the public health emergency (PHE) end date of May 11, 2023, recent actions and releases by both Congress and federal agencies paint a clearer picture of what the post-PHE federal telehealth policy landscape will look like.  In December 2022 with the passage of the Consolidated Appropriations Act of 2023 (2023 CAA), several major federal telehealth policy questions were addressed. Temporary telehealth policies in Medicare such as a waiver of the geographic requirement were extended to December 31, 2024 (Read CCHP’s write up on preparing for the end of the PHE).  However, in recent days the Centers for Medicare and Medicaid Services (CMS) as well as the Drug Enforcement Administration (DEA) have released several fact sheets or proposed rules that address other temporary telehealth policies that were not touched upon by the 2023 CAA.

CMS released a series of provider-specific fact sheets as well as an Overview Factsheetthat addresses what will happen to specific temporary PHE waivers after May 11, 2023.  Among the items discussed were telehealth-specific waivers.  Some of the issues noted were not only ones included in the 2023 CAA or previous actions taken through the regulatory process, but also waivers made during the PHE, the fates of which in a post-PHE environment were unknown until now.  For example, during the PHE providers are able to provide telehealth delivered services from their homes without reporting their home address.  This waiver will continue through December 31, 2023, at which time policy will likely revert back to pre-COVID policy which requires providers to report to CMS the address of where they are when delivering services via telehealth, even if it is their home address.
One other significant clarification made in the Physician and Other Clinicians fact sheetinvolves the list of eligible providers who may continue to provide services via telehealth and be reimbursed by Medicare.  Language in the 2023 CAA indicated that the list of eligible providers would be smaller than what it was during the PHE. The 2023 CAA specified certain provider types such as physical therapists and occupational therapists would still be allowed to continue to provide services during the post-PHE grace period.  During the PHE, CMS allowed all Medicare providers to be eligible telehealth providers.  In the newly released Physician and Other Clinicians fact sheet, it appears that CMS will be continuing this policy of allowing all Medicare providers to be eligible to provide services via telehealth during this post-PHE grace period that will end on December 31, 2024.  Specifically, the fact sheet says:
 CMS has waived the requirements of section 1834(m)(4)(E) of the Act and 42 CFR § 410.78 (b)(2), which specify the types of practitioners who may bill for their services when furnished as Medicare telehealth services from a distant site. The waiver of these requirements expands the types of health care professionals who can furnish distant site telehealth services to include all those who are eligible to bill Medicare for their professional services. As a result, a broader range of practitioners, such as physical therapists, occupational therapists, and speech language pathologists can use telehealth to provide many Medicare services. After the PHE ends, the Consolidated Appropriations Act, 2023 provides for an extension for this flexibility through December 31, 2024.
CCHP has created an At-A-Glance chart of some of the CMS fact sheets that detail the status of the temporary telehealth post-PHE for your use.