Yesterday, January 23rd, the U.S. House of Representatives passed the remaining appropriations bills to keep the federal government opened, including funding for Health and Human Services. The agreement included extensions of several health extenders, including several provisions relevant to home-based care.

Extension of Telehealth Flexibilities (Section 6209)

The legislation extends key Medicare telehealth flexibilities through December 31, 2027:

• Home Health
  • Continues removal of geographic restrictions and expansion of originating sites.
  • Allows the required face-to-face (F2F) encounter to be performed via telehealth through December 31, 2027.
• Hospice
  • Extends the ability to conduct the hospice F2F encounter via telehealth through December 31, 2027.
  • Beginning January 31, 2026, telehealth may notbe used for hospice F2F encounters if:
    • The patient is located in an area subject to a CMS hospice enrollment moratorium
    • The hospice provider is under the Provisional Period of Enhanced Oversight (PPEO); o
    • The encounter is performed by a hospice physician or nurse practitioner who is not enrolled in Medicare and is not an opt-out provider.

CMS is also required to establish a claims modifier or code to identify when an F2F encounter is conducted via telehealth, effective January 1, 2027.

Extension of Funding for Hospice Surveys (Section 6207)

The legislation appropriates an additional $4.4 million for Medicare hospice surveys through the end of calendar year 2026. This funding extension continues survey activities originally authorized under the IMPACT Act of 2014, which had expired at the end of fiscal year 2025.

Extension of Hospice Cap Calculation Adjustment (Section 6218)

The bill extends the IMPACT Act adjustment to the hospice cap amount calculation for FY 2034 and FY 2035. Rather than increasing the hospice cap by the CPI-U, the cap will continue to be updated using the annual payment update percentage. This provision is intended as a budget “pay-for” and is expected to modestly reduce future cap increases.

Extension of Hospital at Home Waivers

The bill extends Hospital-at-Home waivers for 5-years through September 30, 2030.

Next Steps

The legislation is expected to move to a vote in the U.S. Senate when it returns from recess. The situation remains fluid, and changes are possible, but it is an encouraging sign for these critical flexibilities being extended for two years.

HCA will continue to monitor developments closely and keep members informed of any updates, implementation guidance, or operational considerations.