HEALTH Act Permanently Expands Telehealth Access for Rural Clinics, Making Audio-Only Visits Count

The HEALTH Act of 2025 is making a serious play to lock in the telehealth gains we saw during the pandemic, especially for folks who rely on Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). This bill section permanently changes how Medicare pays these community anchors for remote care, and it’s a big deal for accessibility.

The core of the change is simple: audio-only phone calls now officially count as a telehealth visit for Medicare patients using an FQHC or RHC. Before, the rules were much stricter, often requiring video. This bill updates the definition of a “telecommunications system” to explicitly include two-way, real-time audio (Sec. 2). If you’re a parent in a rural area who just needs a quick follow-up with your doctor but has spotty internet or an older phone, this means you can get the care you need without driving an hour or worrying about your data plan. The Secretary of Health and Human Services has 60 days to update the federal rulebook to reflect this.

The Money Trail: Payment Parity for Remote Care

For the clinics themselves, this bill provides crucial financial stability. It mandates that Medicare pay FQHCs and RHCs the same rate for a telehealth visit as they would for an in-person, outpatient visit (Sec. 2). This is called payment parity, and it’s huge because it removes the financial penalty for providing convenient remote care. For a small RHC that relies on every dollar, knowing they’ll be reimbursed consistently for a phone consultation means they can invest in the technology and staff needed to keep offering telehealth services.

Goodbye, Geographic Barriers

Another major win for patients is the permanent removal of “originating site” restrictions when an FQHC or RHC is the provider. Previously, Medicare often required the patient to be in a specific type of facility or geographic area to receive telehealth. This bill removes those geographic handcuffs, meaning FQHCs and RHCs can now provide services to patients regardless of where the patient is physically located (Sec. 2). This is a game-changer for patients who might need specialized services from a particular clinic but live far away, making their local FQHC or RHC a true “distant site” that can serve anyone.

The Catch: Who Pays for the Waiting Room?

While the bill is great for patients and the FQHC/RHC providers, there’s a financial detail that could affect other parts of the healthcare system. When a patient uses telehealth, the facility where the patient is located—the “originating site”—sometimes gets a small facility fee to cover the cost of the room, staff, and equipment. This bill specifically states that if the patient is receiving telehealth from an FQHC or RHC, that facility fee will not be paid to the originating site unless that site is one of the specifically listed types of facilities already defined in existing law (Sec. 2).

What does this mean in practice? If a patient goes to a smaller, non-listed community clinic just to use their private room and reliable Wi-Fi for a telehealth visit with their FQHC provider, that community clinic won't get the originating site fee. This could potentially create a financial disincentive for smaller hospitals or clinics to facilitate telehealth access for FQHC/RHC patients, even as the bill aims to expand access overall. It's a classic policy trade-off: securing payment for the primary provider (the FQHC/RHC) while cutting costs elsewhere in the system.