Telehealth Modernization Act Extends Medicare Flexibility Until 2027, Keeps Audio-Only Visits, and Expands Home Care

The Telehealth Modernization Act is essentially a two-year extension on the way many people get medical care through Medicare. The bill pushes back the expiration dates for most of the popular telehealth flexibilities—like being able to see a doctor virtually regardless of where you live—from September 2025 to September 30, 2027. This includes keeping the option for audio-only (phone call) visits available for two more years, which is a big deal for folks who don't have reliable internet access or the right video equipment. Crucially, the bill delays the rule requiring an in-person follow-up visit for mental health services received via telehealth until October 2027, ensuring continuous access to remote therapy and psychiatry for those who need it.

The Virtual Waiting Room Stays Open

This extension is the core of the bill (Section 2) and impacts millions of Medicare beneficiaries. Think about a student who is on their parent's insurance but is away at college, or a retiree living in a rural area far from the nearest specialist. For them, the ability to connect with their regular doctor via video or even just a phone call is critical. By extending the geographic and site flexibility, the bill ensures that Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) can keep offering these services and get paid for them, treating telehealth essentially the same as an in-person visit until the end of 2027. Without this extension, many people would have been forced back into long drives and time off work just for routine appointments.

Hospital Care Moves to the Couch

Beyond routine checkups, the bill makes a major commitment to high-level care at home. The popular Acute Hospital Care at Home waiver, which allows hospitals to treat patients with certain conditions (like pneumonia or heart failure) in their own homes instead of tying up a hospital bed, is extended until 2030 (Section 4). This is a huge win for patient comfort and hospital capacity. However, the bill also requires a serious, comprehensive study, due by September 30, 2028, to compare the home model against traditional hospital stays. This study needs to look at everything: patient outcomes, readmission rates, infection rates, costs, and even how often family members have to step in as caregivers. The findings of this deep dive will likely determine the long-term future of hospital-level care outside of hospital walls.

Program Integrity: Catching the Scammers Before They Bill

It’s not all about expansion; the bill also tightens up on fraud, particularly concerning Durable Medical Equipment (DME) like wheelchairs or oxygen tanks (Section 5). Starting January 1, 2028, the Secretary can flag certain DME claims for review before payment if they spot "aberrant billing patterns." The red flag? When a doctor orders expensive equipment for a patient they have no prior history of treating under Medicare. This is designed to catch the quick-hit scam operations that pop up just to bill Medicare for unnecessary devices. While this is good for taxpayers, the healthcare industry will need clear guidance on what exactly counts as an "aberrant" pattern to avoid legitimate claims getting stuck in pre-payment review.

Making Telehealth Accessible to Everyone

Recognizing that not everyone speaks English fluently, the bill mandates that the Department of Health and Human Services issue new guidance within a year on how to provide telehealth services to individuals with Limited English Proficiency (LEP) (Section 6). This guidance must cover practical issues: how to seamlessly bring an interpreter into a video visit, how to provide instructions on using the technology in multiple languages, and how to translate patient materials like text reminders. This is a critical step toward ensuring that the expansion of virtual care doesn't leave anyone behind due to language barriers.

New Flexibilities for Chronic Conditions

Finally, the bill opens the door for remote care in two key areas of chronic disease management. First, it allows cardiopulmonary rehabilitation services to be provided via real-time audio and video technology in a patient’s home (Section 7). This means someone recovering from a heart attack can get their rehab sessions remotely, making it much easier to stick with the program. Second, it allows entirely virtual suppliers—those offering services via live video or recorded content—to participate in the Medicare Diabetes Prevention Program (MDPP) until the end of 2030 (Section 8). For someone struggling with pre-diabetes, this means they can access proven prevention programs without needing to find a physical location, vastly expanding the reach of this important health initiative.