Carter optimistic House committees will come to agreement on telehealth extension negotiations

The House Energy and Commerce subcommittee on health voted to pass a two-year Medicare telehealth extension on Thursday along with other legislation that expands reimbursement for health tech. 

The sponsor of the telehealth extension bill, Rep. Buddy Carter, R-Georgia, told Fierce Healthcare he sees no obstacles to the telehealth extension passing the full committee, nor any significant issues for Energy and Commerce and Ways and Means to come to an agreement on a two-year telehealth extension. Carter already conceded to Ways and Means by reducing the scope of the bill from a permanent extension down to two years. 

‘We’ve already changed [our bill] some in order to accommodate what we anticipate coming from [Ways and Means]. Primarily, you know, I wanted to make it permanent, and I think it should be permanent, and I want to leave the door open for it to become permanent,” he said.

Despite Ways and Means passing its own two-year telehealth extension on May 8, Carter said E&C also felt responsibility for ensuring continued access to telehealth. 

“You’ve got somewhat of a territorial rift sometimes between [Ways and Means] and Energy and Commerce, but you know, we’re the health subcommittee of Energy and Commerce, and we consider that to be our responsibility, so that’s why we wanted to do it as well,” Carter said.

Carter has not met with Ways and Means to discuss reconciliation of the two bills. However, he doesn’t think there will be any obstacles to reconciling the two extensions. 

“I don’t anticipate there being much change at all,” he said. 

Carter’s staff told Fierce Healthcare it is engaged in bipartisan discussions and engaging with stakeholders ahead of the full committee markup on potential changes to the legislation.

Members of Telehealth Access for America, a national education campaign, sent a letter to Congressional leadership Wednesday urging them to extend pandemic-era telehealth waivers that are set to expire at the end of the year. 

“Unfortunately, without urgent action from Congress, patients face a telehealth cliff at the end of this calendar year, as critical flexibilities for virtual care, first issued through the PHE and extended by Congress at the end of 2022, once again approach expiration,” the group wrote. 

They continued, saying the extension should be “free of burdensome requirements, like mandatory in-person visits.” Neither the W&M nor E&C telehealth extensions include in-person requirements.

The Affordable Connectivity Program (ACP), an internet discount program utilized by 23 million Americans since its passage in the Bipartisan Infrastructure Act, according to the Federal Communications Commission, was heavily discussed by Democrats and Republicans alike during the markup, who said that telehealth extensions would not benefit Americans that lose access to the Internet. The program has been unwinding since it ran out of funding in April. 

Though both parties supported the continuation of the ACP during the markup, Rep. Nanette Barragán (D-Calif.)  criticized Republicans for not taking action to continue the program past the end of May, when all Internet discounts will be discontinued. Barragán said Republicans gave up many opportunities to pass additional funding for the program already this year. 

The Affordable Connectivity Program Extension Act of 2024, introduced in the Senate and the House, would provide $7 billion to fund the ACP through the end of 2024. 

Carter told Fierce Healthcare he believes the ACP should be extended. Rep. Larry Buschon (R-Indiana) said during the markup that members of the health subcommittee have been participating in a bipartisan and bicameral solution to extend the ACP. 

The subcommittee passed several other telehealth and health tech bills on Thursday. One bill would require a modifier when billing for telemental health services, in part so the Centers for Medicare and Medicaid Services can review the integrity of the visits. Another telehealth bill, the SPEAK Act, would require the Department of Health and Human Services to provide guidance on telehealth services for people with limited English proficiency. 

A key remote monitoring bill also cleared the E&C health subcommittee Thursday that would lower the billing threshold for remote monitoring services down to two days’ worth of data collection, rather than the 16 days that is currently required to bill the codes. 

Lowering the data reporting requirement is contentious among remote monitoring advocates. Proponents say a 16-day data reporting billing threshold is too high for providers to get paid for providing remote monitoring services. A two-day billing threshold would benefit patients with conditions like obesity, who shouldn’t be required to step on a scale every day of the month, they say. 

Detractors of lowering the billing threshold worry a two-day data reporting requirement would decrease the quality of care. 

Ranking Democrat Frank Pallone expressed concern with the two-day billing threshold, saying it may be inappropriate for some conditions. He ultimately supported the bill, which passed unanimously. 

The health subcommittee also passed a bill that would allow virtual-only diabetes prevention program providers to qualify for Medicare payment through the Medicare Diabetes Prevention Program (MDPP) for two years. Popular diabetes prevention programs like Omada Health, which is available to every 1 in 10 Americans through insurance, currently cannot receive payment from the MDPP due to the restriction. Washington Democrat Kim Schrier and Florida Republican Gus Bilirakis both argued for a longer trial period, or permanence.