S. 2709: Telehealth Modernization Act

The Telehealth Modernization Act (S. 2709) is designed to amend the Social Security Act with the aim of extending certain telehealth flexibilities under the Medicare program. Key provisions of the bill are outlined below:

Extension of Telehealth Flexibilities

The bill proposes to extend various flexibilities related to telehealth services for two additional years, pushing deadlines for certain provisions from September 30, 2025, to September 30, 2027.

Geographic and Site Requirements

• Removing Geographic Limits: The bill seeks to eliminate geographic restrictions on telehealth services, allowing individuals in previously limited regions to access telehealth care.
• Expanding Originating Sites: It expands the types of locations from which patients can receive telehealth services.

Practitioner Eligibility

The bill intends to expand the list of healthcare professionals who can provide telehealth services under Medicare, increasing accessibility for patients.

Federally Qualified Health Centers and Rural Health Clinics

Telehealth services provided by federally qualified health centers and rural health clinics will continue under the amended rules, including payment structures aimed at recognizing and compensating these services appropriately.

Delaying In-Person Requirements

• The bill delays requirements for in-person visits related to mental health services via telehealth. Specifically, certain mental health visits that can be conducted through telehealth will be allowed to continue without in-person requirements until October 1, 2027.
• It ensures that this vision applies to visits conducted by rural health clinics and federally qualified health centers as well.

Audio-Only Telehealth Services

The ability to provide telehealth services using audio-only technology will also be maintained, allowing people without internet access to access care until September 30, 2027.

In-Home Cardiac Rehabilitation

The act updates regulations surrounding in-home cardiopulmonary rehabilitation, enabling services to be offered through both audio and video technology in a patient's home.

Diabetes Prevention Framework

Entities providing online diabetes prevention services may enroll in Medicare’s Diabetes Prevention Program, with clearer guidelines from January 1, 2026, allowing services to be offered remotely without restrictions on beneficiaries' locations.

Program Integrity for Durable Medical Equipment

Strengthened integrity requirements for claims related to durable medical equipment under Medicare are also included, such as a new system for tracking and reviewing claims to identify and prevent fraud.

Guidance for Limited English Proficiency

The bill requires the Secretary of Health and Human Services to issue guidance that aids telehealth providers in serving individuals with limited English proficiency. This will include best practices for using interpreters and ensuring accessibility of digital services.

Future Studies and Improved Funding Models

A requirement for the Secretary to conduct studies assessing the effectiveness of these telehealth and home care initiatives and provide reports by specific deadlines ensures that the programs are continually evaluated for performance and improvement.

Extending Home Hospital Care Waivers

The bill seeks to prolong waivers that allow certain hospitals to provide care at home, extending the timeframe for these initiatives through 2030.

Additional Flexibilities

The legislation also provides for more flexible regulations surrounding the use of telehealth in hospice recertification processes, admitting room for telehealth interactions within the recertification framework.

Regulatory Mandates

Overall, the act mandates regulatory reviews and updates to ensure that telehealth avenues remain available and effective for a wider population range over the next several years.

Relevant Companies

• AMGN - Amgen may benefit from increased telehealth services for their patients using their therapeutic drugs.
• CME - CME Group could experience shifts in healthcare insurance premium adjustments related to telehealth service coverage.
• UNH - UnitedHealth Group may see an impact in terms of member engagement and costs related to telehealth service funding.