Senators: Make Telehealth Flexibilities Permanent for Hospice, Other Settings

A group of U.S. Senators are calling on their colleagues in Congress and federal agencies to make permanent the increased availability of telehealth that was established temporarily to maintain continuity of care while limiting the spread of COVID-19.

The lawmakers made their views known in a letter penned by Sen. Brian Schatz (D-Hawai) to Senate majority leader Mitch McConnell (R-Ky.) and minority leader Chuck Schumer (D-N.Y.); 30 senators were signatories on the letter.

Among the provisions cited by the senators was the ability of hospice practitioners to recertify patients for hospice via telehealth, rather than in-person face-to-face encounters.


“We have long advocated for increasing access to telehealth because of its potential to expand access to health care, reduce costs, and improve health outcomes. Telehealth has proven to be pivotal for many patients during the current pandemic, ensuring they receive the care they need while reducing the risk of infection and the further spread of COVID-19,” Schatz wrote in the letter. “We have all heard from our constituents about how effective and convenient it is. Expanded Medicare coverage of telehealth services on a permanent basis — where clinically appropriate and with appropriate guardrails and beneficiary protections in place — would ensure that telehealth continues to be an option for all Medicare beneficiaries after the pandemic ends.”

Declaration of a national disaster, as the president did in response to the pandemic, allows the U.S. Department of Health and Human Services (HHS) to waive certain regulatory requirements under section 1135 of the Social Security Act. CMS issued 1135 waivers to relax conditions of participation (CoPs) for hospices and other health care providers after the White House declared the outbreak a national emergency. Several of these waivers allow for expanded use of telehealth.

During the pandemic, hospices may provide interdisciplinary services via telemedicine or audio as long as the patient is receiving routine home care level of care and those telemedicine services which are audio-only services are capable of meeting the patient and caregiver needs.


The recently enacted $2.2 trillion CARES Act, designed to help the economy and essential industries weather the impact of the pandemic, also contained provisions related to hospice telehealth, including permitting practitioners to recertify patients via telemedicine appointments rather than face-to-face encounters.

Hospice groups have also advocated for the permanent expansion of telehealth, including the National Hospice & Palliative Care Organization and the National Association for Home Health and Hospice.

The senators additionally proposed that federal agencies collect and analyze more data on telehealth utilization, including quality, health outcomes, and spending.

“Americans have benefited significantly from this expansion of telehealth and have come to rely on its availability. Congress should expand access to telehealth services on a permanent basis so that telehealth remains an option for all Medicare beneficiaries both now and after the pandemic,” the letter said. “Doing so would assure patients that their care will not be interrupted when the pandemic ends. It would also provide certainty to health care providers that the costs to prepare for and use telehealth would be a sound long-term investment.”

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