Telehealth Flexibilities at Risk as Shutdown Looms
Telehealth Flexibilities at Risk as Shutdown Looms
Partial Government Shutdown Looms, Telehealth Flexibility Uncertain
Events in Minneapolis, Minnesota last weekend increased the possibility of a partial Federal Government shutdown. This marked a significant shift from last week's Alliance Update in which the government was on track to remain open, and telehealth flexibilities were set to be extended for two years. However, after last Saturday's incident in which another Minnesotan was shot and killed by federal agents, bi-partisan backlash and Democratic spurred calls to block passage of the remaining minibus package until reforms to the Department of Homeland Security (DHS) appropriation bill are agreed to. In its current iteration, the minibus appropriations package funds the Departments of Defense, Labor, Health and Human Services, Education, Transportation, Housing and Urban Development, Treasury and Homeland Security.
Democrats are proposing to separate the DHS funding from the remaining 5 appropriations measures so as not to trigger a partial shutdown of federal agencies unrelated to DHS. However, Republicans do not support this effort. The U.S. House of Representatives already passed the minibus last week and is not in Washington this week to vote. This means that any compromise or changes to the House-passed version will have to pass the House again, making some sort of partial government shutdown highly likely on January 30th.
Given this uncertainty, HCA continues to recommend that home health agencies and hospices plan for telehealth F2F flexibilities to end on January 30, consistent with the guidance we shared last September.
Hospice considerations:
Agencies may want to review upcoming hospice F2F encounter due dates (which must occur within 30 days prior to the third or subsequent benefit period). If an F2F encounter falls within the 30 days following January 30 (through March 1) and the hospice intends to use telehealth, it may be prudent to complete the encounter no later than January 30.
Agencies may want to review upcoming hospice F2F encounter due dates (which must occur within 30 days prior to the third or subsequent benefit period). If an F2F encounter falls within the 30 days following January 30 (through March 1) and the hospice intends to use telehealth, it may be prudent to complete the encounter no later than January 30.
Home health considerations:
F2F timing can be more difficult to anticipate in home health. However, if an agency is aware that an F2F encounter will be needed within the home health timeframe (90 days prior to or 30 days after the start of care), and the physician or allowed practitioner plans to conduct the encounter via telehealth, agencies may want to ensure all parties are aware of the January 30 expiration so appropriate planning can occur.
F2F timing can be more difficult to anticipate in home health. However, if an agency is aware that an F2F encounter will be needed within the home health timeframe (90 days prior to or 30 days after the start of care), and the physician or allowed practitioner plans to conduct the encounter via telehealth, agencies may want to ensure all parties are aware of the January 30 expiration so appropriate planning can occur.
Medicaid reminder:
Telehealth policies for Medicaid are state-specific and are not directly impacted by the January 30 federal deadline. That said, Massachusetts has historically indicated that it will follow federal policy regarding F2F encounters conducted via telehealth, so agencies should be mindful of potential downstream state implications if federal flexibilities lapse.
Telehealth policies for Medicaid are state-specific and are not directly impacted by the January 30 federal deadline. That said, Massachusetts has historically indicated that it will follow federal policy regarding F2F encounters conducted via telehealth, so agencies should be mindful of potential downstream state implications if federal flexibilities lapse.
HCA will continue to monitor this closely and share updates as new information becomes available.
FRIDAY Jan 30 3:23 PM
UPDATE
As we updated you this week, extension of telehealth flexibilities has been uncertain this week despite the U.S. House of Representatives passing the HHS appropriation bill which extends Telehealth flexibilities for two years. But after last weekends events in Minneapolis, passage of the minibus package (including DHS and HHS funding), became unlikely as Democrats demanded reforms though the DHS bill.
Yesterday afternoon, the White House and Senate Democrats reached a deal to pass 5 of the appropriations bills (including HHS funding) as the House did last week, and pass a temporary continuing resolution for DHS while the legislative and executive branch negotiate DHS reforms.
This afternoon (1/30) the U.S. Senate will pass this package, which will then need to be passed by the U.S. House. Because the House was on recess this week, they cannot pass that legislation until Sunday or Monday - meaning that a short-term shutdown of these 6 agencies will ensue. Typically this does not incur much disruption as most federal employees do not work weekends, however it will mean that telehealth flexibilities will expire at midnight tonight, January 30th.
This shutdown is only expected to last until Sunday or Monday at which point the U.S. House is expected to pass this package and extend telehealth flexibilities for two years. We expect that there will be retroactive approval of telehealth flexibilities back to 1/31 and 2/1. However, that is not guaranteed and we continue to advise members to prepare for this temporary lapse in flexibilities.
We will notify members next week when this issue is behind us.
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