Providers Get Good News on Hospital at Home, Telemedicine Prescription Waivers
By Eric Wicklund
Congress is moving forward with a bill that would extend the CMS Acute Hospital Care at Home (AHCaH) waiver for another five years.
The U.S. House of Representatives recently passed the Hospital Inpatient Services Modernization Act (H.R.4313), sending the bill on to the Senate for its vote. The bill, if approved, would extend the deadline on the 2020 waiver for Medicare reimbursement to 2030, while also requiring the Health and Human Services Secretary to conduct a study of the program and report back to Congress by September 30, 2028.
Advocates hailed the move as proof that the program, which enables health systems and hospitals to provide hospital-level care at home through platforms that include in-person visits, digital health and virtual care, is proving its value.
“Medicare beneficiaries will continue to have access a proven care model that reduces complications, shortens recovery times, and strengthens bed capacity for patients with life-threatening or complex illness requiring intensive medical care and monitoring,” Alexis Apple, the American Telemedicine Association’s director of federal affairs and head of federal government affairs for its lobbying arm, ATA Action, said in a press release. “This is a perfect example of how our government should work, to proactively protect the needs of our most vulnerable patients and allow healthcare providers to deliver proven care that has demonstrated strong clinical outcomes, high patient satisfaction, and substantial cost savings for the Medicare program.”
This isn’t the only bit of good news for telemedicine supporters. The U.S. Drug Enforcement Administration is reportedly extending its pandemic-era waiver on telemedicine prescribing for a fourth time, giving healthcare leaders another reprieve on using virtual care channels for behavioral health and substance abuse treatment. The DEA notice, issued on November 10, indicates the extension is still pending regulatory review, so there’s no news on how long this one will last.
This issue has been plaguing providers for much longer. The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 created guidelines for the virtual prescribing of controlled medications, including a provision that a provider see a patient in person before moving to telemedicine. The law also established strict telemedicine guidelines and mandated that the DEA create a special registration for telehealth providers.
The DEA has been dragging its feet on creating that process for close to two decades. In 2020, during the height of the pandemic, it enacted a waiver allowing providers to prescribe via telemedicine without the in-person requirement.
Also up in the air are a series of CMS waivers for telehealth use and reimbursement that were also enacted in 2020. Like the AHCaH waiver, they lapsed during the government shutdown, then were extended by Congress until January 30, 2026. There are bills before Congress to extend those waivers as well, though no action has been taken.
Advocates, including the ATA and the Alliance for Connected Care, are leading the effort to make all of these waivers permanent, arguing that healthcare leaders can’t make long-term decisions on virtual care strategy without knowing those rules will remain in place.
Eric Wicklund is the senior editor for technology at HealthLeaders.