NEW DEVELOPMENT 12/19/24: Congress has changed direction and the CR may change in the coming days, NBCC will provide a more detailed update in early 2025!
Continuing Resolution Bill Contains Several Telehealth Extensions through 2026
On Dec. 17, Congress released a bill to keep the federal government running until March 14, 2025. The legislation, known as a continuing resolution (CR), will fund all federal agencies until March at 2023–24 budget levels. The government has been running on a CR since the end of September as Congress could not develop a final 2024–25 budget at that time.
The CR includes 500 pages of health care-related provisions. The House and Senate are expected to vote on the CR on Dec. 20 and send it to President Biden so it can become law by that date when the current CR expires, in order to avoid a potential federal agency shutdown.
The bill includes all of the key provisions in the Telehealth Modernization Act that passed the Energy and Commerce Committee back in September. The proposed CR continues many telehealth flexibilities for an additional 2 years, through the end of 2026:
- a moratorium on the required in-person visit within 6 months of a preliminary telehealth visit for mental health treatments
- the home of a beneficiary as the originating site (i.e., the location of the beneficiary) for all services
- inclusion of all Medicare beneficiaries to receive telehealth services
- all types of practitioners (e.g., physical therapists, audiologists) providing telehealth services, as determined by the Centers for Medicare & Medicaid Services (CMS)
- Medicare-approved practitioners using audio-only services for the provision of telehealth services
- rural health clinics and federally qualified health centers serving as a distant site (i.e., the location of the health care practitioner)
- employers’ ability to cover telehealth services immediately for employees with high-deductible health plans, bypassing the usual deductible requirements
The telehealth flexibilities had been set to expire on Dec. 31.
The proposed CR contains important payment provisions including that all Medicare providers will see their payments reduced by only 0.3%, a significantly smaller cut than the 2.8% reduction in the final Medicare Physician Fee Schedule. Lawmakers are considering potential reforms to Medicare’s provider compensation structure in the coming year.
The legislative package includes new restrictions on Pharmacy Benefit Managers (PBMs). The proposed regulations would ban PBMs from tying their Medicare compensation to drug prices, enhance industry transparency, and implement new controls over PBM reimbursement for Medicaid prescription drugs.
The CR includes provisions to expedite FDA review of generic drugs. Though manufacturers of generic medications must prove their products contain identical active and inactive ingredients at the same concentrations as brand-name drugs, the new measure requires the FDA to explicitly identify any concentration variations between generic and branded versions.
The package includes $100 billion in disaster aid to address ongoing issues resulting from Hurricanes Helene and Milton, and other natural disasters.
NBCC will provide a detailed summary of the final CR bill early next year that will contain additional information on telehealth and other health-related provisions such as addressing the opioid crisis and digital privacy.
