On December 29, 2022, President Joe Biden signed the year-end $1.7 trillion Omnibus bill designed to extend telehealth services and hospital-at-home waivers for another two years. This legislation aims to avoid a government shutdown in hopes of providing numerous healthcare provisions for long-term care patients nationwide. 

An excellent win for telehealth services, this bill is also poised to reduce the 2023 Medicare payment cuts from 4.5 percent to only 2 percent. The spending bill also includes a two-year extension of telehealth-related regulatory flexibilities for Medicare beneficiaries put in place during the COVID-19 pandemic. In addition to these benefits, the bill also protects the Acute Hospital Care at Home Program for those that receive treatment in home settings. 

We know that it’s a lot to take in, but we’ve managed to break down the key points from the Omnibus bill and how they will all affect Telehealth services going forward. In this post, we’ll take a look at three pivotal components of this extension: 

  • Medicare cuts 
  • Flexibilities in Telehealth Services 
  • Affect on the Acute Hospital Care at Home Program



    Omnibus Bill to Consist of Medicare Cuts and Redeterminations 

    Among the alterations in the Omnibus bill, Medicare provider cuts were planned. While the legislation allows states to resume Medicaid eligibility determinations for telehealth services first established under the COVID-19 public health emergency (PHE), the bill did not cut Medicare payments for physicians as much as was expected. 

    At the beginning of January 1, 2023, physicians were faced with an 8.5% total Medicare payment cut, with an additional 2% cut phased back earlier in 2022. However, the bill waived the 4% Pay-As-You-Go sequester cuts scheduled for this year. With all of these amendments, the Omnibus bill brought Medicare payment cuts from 4.5% to 2%.

    These cuts are not the only changes in the spending bill. PALTC practices everywhere should prepare for mass amounts of Medicare redeterminations for those deemed eligible during the PHE. Starting April 2023, states will be allowed to begin these eligibility assessments. This will involve practices nationwide checking to ensure that Medicaid beneficiaries meet the appropriate requirements.

    Flexibilities in Telehealth Services 

    With this new Omnibus bill, new flexibilities will likely affect many services. Flexibilities that include eliminating geographic restrictions on original sites for Telehealth services. These changes also enable Medicare beneficiaries to receive care from any location of their choosing, allowing more flexibility in scheduling Telehealth services. In addition to these flexibilities, federally qualified health centers and rural health centers are now allowed to continue providing the Telehealth services they offer.

    Additionally, Omnibus dictates that waivers life the inceptive in-person care requirements for those receiving mental health services. This would include continued coverage of strictly audio-only telehealth services.

    These changes within the Omnibus spending bill are intended to broaden the horizons of telehealth and allow those still recovering from the pandemic the opportunity to continue receiving care from the comfort of their own homes.

    The Omnibus Bill and the Acute Hospital Care at Home Program 

    Many were concerned over the status of the Acute Hospital Care at Home Program once the Public Health Emergency (PHE) ended. Back in November 2020, the Centers for Medicare and Medicaid Services (CMS) introduced this program in hopes of providing treatment for common acute conditions in home settings. During the pandemic, this program improved health outcomes for thousands of patients while cutting costs for PALTC practices everywhere.

    Now, these practices can rejoice that the Omnibus bill covers the extension of the Acute Hospital Care at Home Program for another two years with other Telehealth services. To put the impact of this into perspective, as of December 16 of last year, 259 hospitals across 37 states were still participating in this program.

    Omnibus Bill Wrapped-Up 

    With the simple scratch of a pen, President Joe Biden has breathed new life into the world of Telehealth with the new Omnibus bill. Along with the two-year extension of Telehealth services, there will be new flexibilities that will benefit PALTC practices along with the extension of the Acute Hospital Care at Home Program.

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