Congress has extended the pandemic-era telehealth flexibilities through March 31, 2025.

Early Saturday, legislators approved a continuing resolution to fund the government and avoid a shutdown. The bill contained language to extend the flexibilities, which includes the ability to perform face-to-face recertifications via telehealth. They were originally slated to expire on Dec. 31.

The extension is a win for health care providers, including hospices, who have come to rely heavily on virtual services during the past five years. The bill now goes to President Joe Biden for signature.

“The extensions in this legislation are very meaningful for countless Americans and would give our health care providers and hospital systems some certainty and the confidence needed to continue to invest in needed telehealth services,” said Kyle Zebley, senior vice president of public policy for American Telemedicine Association, in a statement.

However, uncertainties still loom as to what might happen after the flexibilities’ new expiration date. Some hospice leaders have said that chaos would result if they expire.

Telehealth has enabled short-staffed hospice providers to address patient needs more quickly, provide extra layers of support and avoid unnecessary home visits. It has also helped them better reach patients in rural areas and hard-to-access locations.

In October, a coalition of hospice, home health and palliative care organizations called on Congress to extend the flexibilities to help ensure continued access to quality care among vulnerable patient populations.

“Telehealth is an effective means of conducting these administrative visits without increasing Medicare costs,” the coalition stated in its letter to Congress. “Extending this flexibility, especially in rural and high-traffic urban areas, will significantly benefit both patients and providers. We strongly urge Congress to ensure the hospice [face-to-face (F2F)] telehealth flexibility is included in any telehealth package before it expires at the end of the year.”

Several state-based hospice and palliative associations signed the letter. Signatories also included the National Alliance for Care at Home, LeadingAge, the National Partnership for Healthcare and Hospice Innovation (NPHI), the National Coalition for Hospice & Palliative Care, American Academy of Hospice and Palliative Medicine and chaplain and nursing associations, among others.

Many stakeholders want to see the flexibilities become permanent, but to date the U.S. Centers for Medicare & Medicaid Services (CMS) has given no indication that it would do so.

In a March hearing before the U.S. House Ways and Means Committee, U.S. Health and Human Services (HHS) Secretary Xavier Becerra said that HHS was willing to make them permanent. However, he said this would require closer collaboration with state governments.

“We’re with you. We can’t allow those flexibilities to expire, and we need to work closer with our state partners, because much of the flexibility that comes from telehealth means being able to go over state lines,” Becerra said. “Right now, because states decide who gets licensed to do care, we have to have the cooperation of the states so we can go beyond its own state borders.”