House Ways and Means Committee introduces a bill to extend telehealth services for two years and includes PBM reforms.

The House Ways and Means Committee has proposed a bill that extends telehealth services for two years while also incorporating reforms for Pharmacy Benefit Managers (PBMs), aiming to enhance healthcare accessibility and efficiency.

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The House Committee on Ways and Means Monday night unveiled a first-of-its-kind piece of telehealth extension legislation to preserve Medicare telehealth flexibilities for two years. 

Telehealth lobbyists told Fierce Healthcare on the sidelines of the American Telemedicine Association annual conference in Phoenix this week that they are happy with the extension, though they prefer telehealth permanency. 

The House Energy and Commerce Committee will likely follow suit in the next week, a source said, further entrenching the battle between the two committees to get a telehealth extension through the House. 

The Ways and Means legislation introduced by Rep. David Schweikert, R-Arizona, the Preserving Telehealth, Hospital and Ambulance Access Act, extends Medicare telehealth flexibilities such as allowing telehealth visits to be conducted from anywhere, delaying the in-person requirement for the provision of telemental health services and extending audio-only telehealth. The flexibilities are currently set to expire at the end of the year if Congress doesn’t act. 

The bill also ropes in a longer, five-year extension for the Centers for Medicare & Medicaid Services’ Hospital at Home waiver program, which allows enrolled hospitals to receive payment for acute-level hospital care provided at home. The bill also touches on wearable medical devices, the integration of AI and how Congress should create policies to maximize their benefit and minimize their harm. 

Schwiekert’s bill includes several guardrails for the two-year telehealth extension, which some members of Congress have called for during recent telehealth hearings. One major concern is the fraudulent ordering of high-cost durable medical equipment and clinical diagnostic tests through telehealth. 

The House Energy and Commerce Committee told stakeholders Monday it will hold a health subcommittee markup next week. Though the committee hasn’t disclosed what legislation will be included in the markup, a source close to the issue told Fierce Healthcare that it has been working on a telehealth extension bill. 

The source predicts the hearing will include the telehealth extension legislation because the Energy and Commerce Committee has been committed to following regular order, and its last legislative health subcommittee hearing in April was on telehealth and other at-home healthcare services. 

The offsets for the bill include pharmacy benefit manager reforms one source said were included in Senate Finance Committee PBM transparency legislation, the Modernizing and Ensuring PBM Accountability (MEPA) Act introduced in 2023.

Two sources told Fierce Healthcare it’s likely the House will move on telehealth before the lame-duck session, possibly by August. It’s unclear where telehealth falls on the Senate’s list of priorities.

Source: Fierce Healthcare