The FY22 omnibus appropriations bill restores and extends the IRS exception on telehealth services for individuals with HSA-eligible High Deductible Health Plans (IRS Code Sec. 223 (c)) through the end of this calendar year.  This reinstates the original exception included in the CARES Act, which expired January 1, 2022, from March 31, 2022, through January 1, 2023. The bill also grants a five-month extension to Medicare telehealth flexibilities tied to the pandemic. It also contains several provisions that will tee up a congressional review of telehealth services in an effort to pass legislation to make many of these exceptions permanent:  The bill requires HHS to begin publishing utilization and claims data on the CMS website on telehealth as of July 2022.  It mandates a MEDPAC report to Congress on utilization and payment policy on telehealth as well as an HHS OIG report to on program integrity by July 2023.  

 

The House is voting on the bill today but the House Rules Committee has released the text of a short-term CR to extend funding by four days to March 15 as a potential stop gap. The Senate could and should UC or vote on this tonight/tomorrow and avert any talk of a shutdown in what amounts to a wartime footing—but it only takes one to derail that. That said, I don’t think anyone believes there will be a shutdown at this point.   

 

Telehealth Exceptions Included in the Omnibus:

 

Title III – Medicare, Subtitle A—Telehealth Flexibility Extensions: Flexibilities granted in Medicare during the COVID-19 Pandemic to facilitate provision of healthcare services using telehealth or other digital or virtual care modalities are extended for 151 days after the expiration of the HHS Public Health Emergency Declaration.

 

Sec. 307. Internal Revenue Code Amendment:  - Extension of Exemption for Telehealth Services from Certain IRS Rules Regarding High Deductible Health Plans.  The original exception included in the CARES Act, which expired January 1, 2022 has been renewed from March 31, 2022, through January 1, 2023. 


 

Sec. 301. Removing Geographic Requirements and Expanding Originating Sites for Telehealth Services. 

 

Sec. 302. Expanding Practitioners Eligible to Furnish Telehealth Services: to include qualified occupational therapists, physical therapists, and speech-language pathologists.

 

Sec. 303. Extending Telehealth Services for Federally Qualified Health Centers and Rural Health Clinics.  

 

Sec. 304. Delaying the In-Person Requirements Under Medicare for Mental Health Services Furnished through Telehealth and Telecommunications Technology. 

 

Sec. 305. Allowing for the Furnishing of Audio-Only Telehealth Services. 

 

Sec. 306. Use of Telehealth to Conduct Face-To-Face Encounter prior to Recertification of Eligibility for Hospice Care. 

 

Sec. 308. Reports on Telehealth Utilization: 

• MedPAC Report: Report to Congress on the utilization of telehealth services in the Medicare Program, Medicare program expenditures and payment policy changes for telehealth made during the COVID-19 pandemic – no later than June 15, 2023.

• HHS Inspector General Report: OIG shall report to Congress program integrity and risks associated with Medicare telehealth services including recommendations to prevent waste, fraud, and abuse in Medicare telehealth programs. 

• HHS Publication of Telehealth Data: Beginning July 1, 2022, the Secretary of Health and Human Services shall post on the CMS website Medicare claims data with respect for telemedicine services, data on utilization and beneficiary characteristics.

 

Full Omnibus Bill Legislative Text:

• Bill Text

 

Summaries via House Democratic Appropriators:

• A full summary of the 12 regular appropriations bills is here.  

• A summary of the Ukraine supplemental is here and a one-page fact sheet is here.

• A summary of the coronavirus supplemental is here and a one-page fact sheet is here.

• Labor, Health and Human Services, Education, and Related Agencies: Summary | One-Pager