Chaunte Causey

By Morgan Gonzales, HomeHealthCareNews.com

On Tuesday [February 3, 2026], Congress and President Donald Trump passed the Consolidated Appropriations Act, 2026, reopening the government after it partially shut down for three days, pausing two measures important to the home-based care community.

The bill, passed following a political backlash to funding for Immigration and Customs Enforcement (ICE), funds most of the government through Sept. 30, 2026. It extends certain telehealth flexibilities for two years and extends the Medicare Acute Hospital Care at Home waiver for five years.

On the telehealth flexibility front, the funding package allows the face-to-face visit to be performed via telehealth – a flexibility that extends home health providers’ patient pools and avoids some back-office burden. While home health providers will benefit from this extended flexibility, the funding package does not allow for telehealth flexibilities for hospice providers in some circumstances, including if the person receiving hospice care is located in an area where CMS has placed a moratorium on enrolling hospice providers and if the person is receiving care from a provider subject to the Provisional Period of Enhanced Oversight (PPEO). The National Alliance for Care at Home said in a statement that the organization was “concerned” about these limitations for hospices.

For the hospital-at-home waiver program, the five-year extension adds an element of at least short-term certainty after the program has been kept alive by a series of short-term measures. Regulatory uncertainty has caused a “wait and see” moment for the industry, and was cited as the reason for Inbound Health’s closure.

“For patients, this means fewer disruptive hospital stays, more healing at home, and greater access to high-quality acute care – especially for older adults and those in rural communities,” Pippa Shulman, chief medical officer of hospital-at-home operator DispatchHealth, said in a LinkedIn post. “For health systems, it provides the stability needed to invest in innovation, build teams and scale programs that reduce crowding, improve outcomes and meet people where they are.”

Additionally, the bill streamlines the enrollment process for providers serving people under 21 in a state other than their primary Medicaid enrollment.

By Jim Parker, HospiceNews.com

An extension of the COVID-era telehealth flexibilities is wallowing in Congress but will likely pass soon. The flexibilities expired Jan. 30.

The extension is tied up in a funding bill for several federal agencies. The bill has been stymied by debate over funding for U.S. Immigration and Customs Enforcement (ICE) amid concern over aggressive tactics used by those agents in several U.S. cities. This has led to a partial government shutdown. However, many observers believe that the telehealth provision will move forward within the coming week.

“It is likely the shutdown will be short-lived, expected to end next week when House members are expected to return for a vote,” the National Alliance for Care at Home indicated in an alert to its members. “The Alliance recommends that home health agencies and hospices prepare for the telehealth flexibilities to end on Jan. 30, as we have previously recommended. While it would be anticipated that there would be a retroactive approval of the telehealth flexibilities that covers the anticipated short shutdown period, it is not guaranteed.”

The telehealth extension provisions are contained in a single-package appropriations legislation, which would extend the flexibilities through the end of 2027. This includes the ability of hospices to perform patient re-certification face-to-face encounters via telehealth.

This would also include waivers that expanded the scope of practitioners eligible to provide telehealth services, as well as flexibilities that removed geographic requirements and expanded originating sites for telehealth services, including federally qualified health centers and rural health clinics.

Hospices and other health care providers have increasingly relied on virtual services over the past five years under telehealth waivers, particularly to reach patients in rural and remote areas with limited access to care.

Telehealth has enabled hospices to serve a growing patient population amid rising demand and persistent staffing shortages intensified by the pandemic. Virtual care has also expanded support for patients and caregivers, allowing providers to reduce unnecessary home visits while better managing clinician workloads.

CMS Administrator Dr. Mehmet Oz in his Senate confirmation hearing indicated that expanding telehealth utilization is a “major focus” for the agency.

“Congress has a responsibility to extend telehealth widely throughout the nation, and as it was during COVID …” Oz said. “It is a major focus of mine, and if confirmed, it’s one of the areas I think we’ll be able to make major inroads, because there are no opponents to this.”

However, no CMS action on telehealth has materialized to date.

The expiration, even if short lived, could create widespread disruption for hospice providers, according to Logan Hoover, vice president of policy and government relations for the National Alliance for Care at Home.

“There will be a tremendous amount of unnecessary disruption. This flexibility has been in place for almost six years; it has become a standard part of operations,” Hoover previously told Hospice News. “The consequence for a hospice using telehealth during a lapse in authority to conduct the face-to-face visit could be not being paid at all for the entire benefit period, making the hospice liable for thousands of dollars. Worse, the requirement could delay a patient’s access to hospice care if the visit is required before service begins.”

By Marika Miller, Foley & Lardner LLP

Key Takeaways

• The Medicare telehealth flexibilities are set to expire on January 30, 2026. Without Congressional action, Medicare coverage for telehealth services will revert to the limited pre-COVID-19 framework.
• The House has passed legislation that would extend the flexibilities through December 31, 2027, but the bill still needs to pass the Senate and be signed into law.
• Due to disagreement in Congress over Department of Homeland Security (DHS) funding, the risk of another partial government shutdown and lapse in the flexibilities is increasing.
• The Centers for Medicare & Medicaid Services’ (CMS) response during the lapse of telehealth coverage in fall 2025 provides a roadmap for providers on what to expect.

What Is at Stake

Without an extension from Congress, the Medicare telehealth flexibilities will expire on January 30, 2026. This would mean that Medicare telehealth coverage, as we have known it for nearly six years, would revert to a time when Medicare generally covered telehealth services only for beneficiaries located in rural areas, at a limited set of originating sites (such as hospitals, clinics, and skilled nursing facilities), and when services were furnished by a much narrower group of practitioners. Under this framework, coverage of telehealth services for Medicare beneficiaries is significantly narrowed, making telehealth less accessible for many beneficiaries due to cost concerns. For a more detailed discussion of what Medicare telehealth policy looks like after expiration, see our prior comments “Medicare Telehealth Flexibilities: Countdown to September 30, 2025.”

Where Congress Stands Now

On January 22, 2026, the House passed H.R. 7148, the 2026 Consolidated Appropriations Act, which includes the FY 2026 appropriations package for Defense, Labor, Health & Human Services, Education, Transportation, Housing and Urban Development, and related agencies. The spending bill would extend the Medicare telehealth flexibilities through December 31, 2027, and the Acute Hospital Care at Home initiative through September 30, 2030.

The current dispute over DHS funding, including disagreement among Senators regarding how to fund and oversee agencies such as Immigration and Customs Enforcement following recent federal law enforcement encounters in Minneapolis, increases the likelihood of another government shutdown that could temporarily disrupt Medicare telehealth coverage. However, because there is little disagreement in Congress over maintaining telehealth access for Medicare beneficiaries, it is likely that any final spending package will include some form of an extension of the Medicare telehealth flexibilities. That said, because the flexibilities are entangled with the broader DHS funding debate, it is unclear whether Congress will enact the proposed two-year extension or instead rely on shorter-term extensions.

A Brief History

Congress first implemented the Medicare telehealth flexibilities during the COVID-19 Public Health Emergency (PHE) in 2020. The flexibilities were later extended, or made permanent in certain cases, through the 2021 Consolidated Appropriations Act (CAA), 2022 CAA, 2023 CAA, 2025 American Relief Act, 2025 Full-Year Continuing Appropriations and Extensions Act, and most recently through the 2026 Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, which extended the flexibilities through January 30, 2025. For more details, refer to some of our prior discussions about the extensions:

• “Medicare Telehealth Flexibilities Have Expired” (October 2025)
• “Medicare Telehealth Flexibilities: Countdown to September 30, 2025” (September 2025)
• “Medicare Telehealth Flexibilities Get a Three-Month Lifeline” (December 2024)

How CMS Handled the Last Lapse

During the funding lapse in late 2025, CMS directed all Medicare Administrative Contractors (MACs) to place a temporary hold on telehealth claims and to return, rather than deny, telehealth claims submitted during the lapse period that could not be paid under the pre-COVID-19 coverage framework. CMS also advised providers to assess whether it was appropriate to issue beneficiaries an Advance Beneficiary Notice of Noncoverage.

After coverage was restored retroactively, CMS instructed providers to resubmit telehealth claims that had been returned by MACs during the lapse period and to submit all telehealth claims that had been held, provided those claims met all applicable Medicare requirements. CMS also encouraged providers to identify beneficiaries who were charged for telehealth services during the lapse period due to non-coverage for services that later became payable and to submit claims to Medicare and refund any resulting overpayments to those beneficiaries.

What Providers Should Do Now

Given the approaching deadline for the flexibilities and likelihood of another lapse, providers furnishing telehealth services should consider doing the following:

• Prepare for a brief lapse in Medicare telehealth coverage, including a plan for decisions around scheduling, billing, and the timing of claims submissions, in the likely event coverage is later restored retroactively.
• Track telehealth claims provided during any lapse period so those claims can be held, flagged, or resubmitted if coverage is reinstated.
• Prepare patient communications in advance explaining that Medicare telehealth coverage may change, including that visits may need to be rescheduled, converted to in-person, billed differently, or may become non-covered if a lapse occurs.
• Closely monitor future Congressional action on appropriations to quickly adjust scheduling, billing, and care delivery if coverage is restored.

Bottom Line

Without Congressional action, the Medicare telehealth flexibilities will revert, once again, to the pre-pandemic framework on January 31, 2026. Although the House has passed legislation that would extend the flexibilities through December 31, 2027, Senate action remains uncertain. Despite continued bipartisan support for preserving Medicare coverage of telehealth services, the extension is part of a broader appropriations package that has become tied up in disputes unrelated to telehealth policy, most notably negotiations over DHS funding.

As a result, providers should be prepared for the possibility of another short-term lapse in Medicare telehealth coverage, probably similar to the October – November 2025 lapse, even if Congress ultimately enacts an extension that applies retroactively. Fortunately, because this would be the second lapse of the flexibilities, providers can look to CMS’ guidance from the prior lapse as instructive in determining how to handle telehealth claims that would not be covered under the reverted coverage framework.

By Eric Wicklund, Healthleadersmedia.com

Congress is moving forward with a healthcare package that would, among other things, extend the telehealth waivers and the CMS Acute Hospital Care at Home (AHCaH) program.

According to news reports Tuesday out of Washington DC, the bill, part of a package being prepared for a vote to fund government agencies and avoid a potential shutdown, would extend the telehealth flexibilities through 2027 and the AHCaH program through 2030. It would also boost this year’s funding for community health centers to $6.4 billion and enable Medicare coverage for multi-cancer early detection screening tests.

Advocates reacted with cautious optimism to the news, noting that the bipartisan bill will still have to pass muster with GOP fiscal conservatives – and be approved by President Trump.

“We’ve seen before that even strong, bipartisan proposals can face unexpected hurdles late in the process, which is why it’s important not to take any outcome for granted when it comes to Congressional legislation,” Alexis Apple, vice president of federal affairs for the American Telemedicine Association and deputy executive director of ATA Action, said in a press release. “This momentum is real and meaningful, and it is a very good sign that telehealth provisions continue to advance with bipartisan support. We are optimistic this legislation can move forward, as it includes a number of strong bipartisan priorities and is not tied to the more partisan homeland security funding debate currently underway.”

Aside from the extensions, the bill would extend coverage for in-home cardiopulmonary rehabilitation services through 2027; enhance Medicare coverage of durable medical equipment (DME) services; mandate that the Health and Human Services Department issue guidance within a year on improving virtual care services for patients with limited English proficiency; and include digital health companies in the Medicare Diabetes Prevention Program through 2029.

The bill, if passed into law, provides some measure of relief for healthcare leaders mapping out their telehealth and Hospital at Home strategies, but advocates were quick to point out it’s just another in a long line of extensions approved by federal regulators since they were enacted in 2020 during the COVID pandemic.

Without this deal, the telehealth waivers and AHCaH program would expire in less than two weeks.

Supporters say the telehealth flexibilities in particular are needed to help expand and improve virtual care services offered through health systems and hospitals. Without any assurance that they would be permanent, leadership has to develop and fund programs with the understanding that they may have to be shut down when the waivers expire.

Through those flexibilities, the government has:

• Waived geographic restrictions on telehealth coverage and use;
• Expanded the list of providers able to bill Medicare for telehealth services;
• Allowed audio-only telehealth services;
• Eased originating site restrictions on telehealth so that the patient can receive treatment at home;
• Waived the in-person requirement for telemental health treatment;
• Enabled telehealth service for hospice care; and
• Enabled Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to use telehealth.

By Jessica Hall, Marketwatch.com

Telehealth services for Medicare beneficiaries which were slated to end later this month may get a two-year extension that could keep in place the pandemic-era services available to more than 67 million beneficiaries.

Under a funding package released by the U.S. House appropriations committee on Tuesday, Medicare’s telehealth coverage would be extended until Dec. 31, 2027. Policymakers face a Jan. 30 deadline to extend telehealth funding, or coverage that has been in effect since March 2020 will lapse.

Written by Susan Morse, HealthcareFinanceNews.com

The American Telemedicine Association is warning of yet another upcoming telehealth cliff.

There are just 24 days left for Congress to pass a federal budget and to extend the next telehealth deadline, before the government shuts down on Jan. 30, the ATA yesterday.

ATA Action, the affiliated policy and legislative advocacy arm of the American Telemedicine Association, is once again urging Congress to act to avoid another lapse in telehealth services.

The answer is for Congress to make permanent what has been temporary extensions since the end of the COVID-19 public health emergency, the ATA said.

“We are counting on our government champions to find a permanent solution or at least to establish a long-term extension for these telehealth waivers,” said Alexis Apple, deputy executive director, ATA Action, and vice president of federal affairs at the ATA.

Also on the chopping block at the end of the month unless Congress acts are Medicaid Disproportionate Share Hospitals (DSH) cuts and the acute hospital care at home program.

WHY THIS MATTERS

Telehealth and other flexibilities are supported by hospitals.

All are tied up in the government funding package and are of concern, said America’s Essential Hospitals.

THE LARGER TREND

Telehealth and other healthcare flexibilities were threatened in the last government shutdown, which began Oct. 1 and became the longest shutdown in U.S. history. It ended Nov. 12 when Congress reached a budget agreement.

Democrats had held out for a continuation of Affordable Care Act enhanced subsidies but failed to get that pushed through.

The U.S. House of Representatives today was poised to vote on a three-year extension of the tax credits. The legislation is expected to pass the House, but was believed to have no chance in the Senate.

ON THE RECORD

“With only a handful of days left, time is running out for Congress to send legislation to President Trump for signature, extending essential telehealth and digital health services for the Medicare population, as well as for the millions of Americans in rural and urban communities and those with chronic and acute conditions who have come to rely on these virtual care solutions,” said ATA’s Apple. “We realize that Congress is returning to Washington with a number of pressing issues to address, right out of the gate. However, extending these telehealth waivers, originally put in place by President Trump during his first term in office, should be a slam dunk.”

By Marissa Plescia (MedCityNews.com)

In an issue brief released Monday, the American Medical Association (AMA) urged Congress to make permanent the Medicare telehealth flexibilities introduced during the Covid-19 pandemic.

Before Covid-19, only a select few Medicare beneficiaries could access virtual care. They had to be in a rural setting, not an urban or suburban setting. They also could only use telehealth in an approved originating site, like a hospital or a physician’s office. These restrictions were waived during Covid-19 in order to expand access to care.

These flexibilities have been extended numerous times and are currently set to expire at the end of January. This reliance on temporary extensions has created uncertainty for providers and patients, the AMA argued in the issue brief.

“Since the Covid-19 public health emergency, Congress has repeatedly extended telehealth flexibilities for Medicare patients—often at the last moment—creating uncertainty for millions of patients and their physicians,” said AMA President Dr. Bobby Mukkamala, in a statement. “As the current waiver deadline approaches, Congress must finally act decisively to prevent a disruptive and abrupt halt to the expanded telehealth services that have improved care continuity, chronic disease management, and access for rural and underserved communities.”

The issue brief explains that telehealth use surged during the pandemic, with more than 28 million Medicare beneficiaries using virtual care, and studies show telehealth visits are 9.2 percentage points more likely to be completed than in-person appointments.

In addition, multiple studies, including one from the University of Michigan, found that telehealth does not increase overall utilization and can lower costs, with one study showing $82 lower Medicare spending per patient after a telehealth visit compared with in-person care.

The AMA calls for several congressional actions, including permanently removing restrictions on Medicare coverage of telehealth services so patients can receive telehealth at home regardless of location. The organization also asks to extend the Acute Hospital at Home Care waiver through 2030 and authorize continued use of virtual diabetes prevention programs. It is also pushing lawmakers to address coverage and payment barriers for remote patient monitoring devices to improve maternal and child health outcomes under Medicaid.

“When thoughtfully integrated, particularly through coordinated systems and hybrid care models, telehealth has demonstrated the ability to reduce care fragmentation, improve outcomes, enhance patient engagement and lower costs,” the AMA stated in the issue brief. “Real-world data increasingly supports its role in delivering high-quality, efficient care across populations. Yet many telehealth flexibilities remain tethered to temporary pandemic-era policies. Treating them as stopgap measures rather than foundational tools undermines progress toward a modern, innovative and resilient health system.”

WASHINGTON – The U.S. Drug Enforcement Administration, in partnership with the Department of Health and Human Services (HHS), has issued a Fourth Temporary Extension of the COVID-19 Telemedicine Flexibilities for the Prescription of Controlled Medications, extending the current telemedicine flexibilities through December 31, 2026.

Under these telemedicine flexibilities, DEA-registered practitioners are permitted to remotely prescribe Schedule II-V controlled medications via audio-video telemedicine encounters, including Schedule III-V narcotic controlled medications approved by the Food and Drug Administration (FDA) for maintenance and withdrawal management treatment of opioid use disorder via audio-only telemedicine encounters, without having ever conducted an in-person medical evaluation, provided that such prescriptions otherwise comply with the requirements outlined in DEA guidance documents, DEA regulations, and applicable federal and state law.

“DEA supports telehealth access for patients who need medication, but not at the expense of public safety,” said DEA Assistant Administrator Cheri Oz, Diversion Control Division. “These rules aim to protect patients, expand access to care, and close the door on diversion into the illicit drug market.”

DEA recognizes that the expiration of the current telemedicine flexibilities without further regulation could disrupt patient care. This extension provides critical benefits, including:

• Ensuring continuity of care for patients who rely on telemedicine, particularly those in rural and underserved areas, the elderly, and patients with mobility limitations
• Preventing a backlog of patients needing in-person appointments
• Allowing time to finalize and implement regulations that balance access to care with the necessary safeguards against drug diversion

On January 17, 2025, DEA and HHS published two final rules titled Expansion of Buprenorphine Treatment via Telemedicine Encounter and Continuity of Care via Telemedicine for Veterans Affairs Patients (collectively referred to as the “Two Final Rules”). These rules take effect December 31, 2025.

The Fourth Temporary Extension, along with the Two Final Rules, provides three distinct sets of authorities for telemedicine prescribing, each with unique requirements. Practitioners covered by one or both of the Two Final Rules may continue to utilize the telemedicine flexibilities under the fourth temporary rule, which imposes fewer requirements than the Two Final Rules.

For more information: Federal Register :: Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications.

Information provided in a press release from the United States Drug Enforcement Administration.

News from the South Carolina Department of Health & Human Services:

COLUMBIA, S.C. – The Centers for Medicare & Medicaid Services (CMS) announced South Carolina will receive $200,030,252 in federal Rural Health Transformation (RHT) Program funding for fiscal year 2026. The RHT Program was established under the Working Families Tax Cuts Act signed into law by President Trump July 4, 2025.

“Thanks to the hard work of SCDHHS Director Eunice Medina and her team, South Carolina has secured $200 million through President Trump’s Rural Health Transformation Program,” said Governor Henry McMaster. “We will put these funds to work to strengthen rural health care and help ensure South Carolina continues to lead the way in Making America Healthy Again.”

Governor McMaster has designated the South Carolina Department of Health and Human Services (SCDHHS) as the lead agency to implement South Carolina’s RHT Program. The program is a cooperative agreement between CMS and state governments. SCDHHS will work closely with CMS to implement the initiatives described in South Carolina’s application in line with federal requirements, quality standards and funding rules.

South Carolina’s approach to this funding opportunity will emphasize one-time, high-impact investments that remove systemic barriers and build long-term capacity. This investment will enable the state to modernize rural healthcare infrastructure, expand access to essential services and build a resilient, sustainable healthcare system that delivers measurable improvements in health outcomes for generations to come.

South Carolina’s RHT Program application focused on five major initiatives to increase access to quality healthcare services, particularly those that focus on improving chronic disease and maternal health outcomes across the state’s rural communities. They are:

• Connections to Care: Expands digital infrastructure by implementing electronic health records, remote patient monitoring, telehealth services and a statewide resource database platform to improve care coordination and access
• Leveling up: Scales successful pilot programs statewide, focusing on chronic disease management, pediatric care quality and workforce development
• Wellness Within Reach: Deploys mobile health units, crisis response teams and pop up clinics to bring care directly to underserved populations
• Shoring up to Sustainability: Strengthens rural healthcare systems through targeted investments in workforce recruitment and retention, facility upgrades and provider training
• Tech Catalyst Fund: Supports rural health technology startups and community-based innovations to drive long-term health and economic improvements

“The Rural Health Transformation Program provides a once-in-a-generation opportunity to strategically address barriers that have long-hindered access to quality care in our rural communities,” said SCDHHS Director Eunice Medina. “We look forward to working closely with CMS to improve health outcomes across the state by bringing these initiatives to life as quickly as possible.”

South Carolina developed its RHT plan and outcomes-driven initiatives by leveraging longstanding relationships with state agencies, healthcare providers, advocates, community leaders and local and state officials. This produced more than 350 proposals with ideas for inclusion in the state’s RHT Program plan. South Carolina’s RHT application and other information, including the slides and recording from the state’s November 2025 public webinar, are available at https://scdhhs.gov/rhtp.

SCDHHS will provide additional guidance on how stakeholders can learn more about RHT Program funding opportunities. Future webinars and RHT Program guidance will be announced via SCDHHS’ Medicaid bulletins. Healthcare providers and other interested stakeholders can sign up to receive Medicaid bulletins on SCDHHS’ website.