California

Medicare‍ Telehealth Access Faces Uncertainty, ​Disproportionately Impacting ⁤people with Disabilities

The expiration of certain Medicare telehealth flexibilities on October⁢ 1st is creating notable‍ disruption for patients and providers, particularly ‍those serving individuals with disabilities. While behavioral health telehealth remains permanently covered due to a 2021 ‍Congressional decision, access to other ‍vital ⁤telehealth services is ⁤now in question, leading ​to concerns about continuity of care and equitable⁣ access to healthcare.

Data from the Centers for Medicare & Medicaid​ Services (CMS) ‍highlights the importance of telehealth for beneficiaries with ‍disabilities. Nearly 30% of Medicare recipients eligible due to disability utilized telehealth services ⁤in the first quarter ⁤of ‌2025, a figure substantially higher than the approximately 11% of‌ those eligible based on age (65+).

This disruption is‌ directly impacting patients like Charis Hill,a 38-year-old Northern California resident with ankylosing spondylitis,a chronic inflammatory disease. ​hill was recently informed that a scheduled telehealth appointment with their rheumatologist‌ on ⁣October 7th would not be covered​ by Medicare. ⁤Hill, who relies on telehealth appointments​ every three to four months,​ is immunocompromised and hesitant to return to in-person visits due to safety concerns regarding mask protocols. ‌ Thay are now exploring ‌choice‍ coverage‌ options,including Medicaid,and worry about potential loss of access⁢ to specialist care and necessary⁤ medications ‌if a solution‍ isn’t found.

The uncertainty also presents challenges for healthcare providers.⁤ ⁣Jeffrey⁤ Davis, a ⁣director at health policy consultant McDermott+, explains that while there’s anticipation​ of a potential retroactive fix‍ from Congress, there’s no guarantee. Providers are grappling with the decision of whether to⁣ continue⁣ offering⁢ telehealth services without assured reimbursement. Some,‌ lacking the⁣ financial⁤ capacity to absorb potential ‌losses, have already ceased offering these services ‍to⁤ Medicare beneficiaries. CMS advises providers to continue offering telehealth but to inform ​patients of potential non-coverage. Davis notes the resulting confusion among both patients and providers.

Efforts to address the situation are underway.⁣ A bill sponsored ‍by Senator Brian Schatz (D-Hawaii) has garnered 65 co-sponsors – enough for passage in the Senate if brought to a vote.⁢ Though, ⁤the estimated $25 billion cost ‍over ten ⁣years has proven to be a sticking point in ⁤a Congress frequently enough requiring offsets for healthcare spending.

A short-term government funding bill​ passed ​by the House‍ included a provision to extend Medicare telehealth coverage for approximately seven weeks, coinciding with the ⁣length ‌of the continuing resolution. However, this bill has faced opposition in ‍the ​Senate, with ‌Democrats seeking ⁣an extension of ​expiring health care subsidies for individuals purchasing insurance in the individual market.

Despite the current challenges, advocates like Zebley express‌ hope that​ the disruption will galvanize‌ support ​for making Medicare telehealth coverage permanent, possibly leading to a bipartisan solution with the support of President ⁣Trump and Congress.