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Two-year telehealth bill clears another hurdle

May 16, 2024
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Illustration: Tiffany Herring/Axios

An extension of Medicare telehealth flexibilities cleared another significant hurdle Thursday afternoon when the House Energy and Commerce health subcommittee unanimously approved a two-year reauthorization.

Why it matters: It brings the telehealth package a step closer to a floor vote this summer and a possible year-end health deal.

  • The House Ways and Means Committee advanced its telehealth bill last week in an unanimous bipartisan vote.
  • The E&C bill, approved 21–0, still needs to be taken up by the full E&C committee.

What's inside: The E&C package would extend virtual care flexibilities that date to the pandemic and remove geographic requirements while expanding originating sites.

  • It would expand the number of practitioners who can furnish virtual care while retaining flexibilities for federally qualified health centers and rural health clinics.
  • It also delays an in-person requirement before Medicare beneficiaries can access behavioral health services.
  • The E&C health panel also extended for five years a Medicare hospital-at-home program for acute services.

The intrigue: E&C uses two of the same payfors as the Ways and Means bill: a delay in lab test payment rates and language that changes the way PBMs are paid alongside new transparency requirements.

  • The E&C bill, however, doesn't include a hospice offset that Ways and Means' does.
  • The lab test payfor extends the phase-in for Medicare clinical laboratory test payment changes to generate savings.
  • It would have to do a lot of the budgetary heavy lifting. Past estimates for a telehealth extension have been around $2 billion, and the PBM changes are estimated to save in the hundreds of millions.

The health subcommittee also approved 20 other mostly narrow health bills, including measures that would reauthorize the rare pediatric disease priority review voucher program for six years, expand remote monitoring access in Medicare and alter the Medicaid program to prevent fraud and streamline functions.

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