On March 11, 2022, President Biden signed into law legislation that provides funding for the federal government until September 30, 2022.1
Included in the federal funding law was an extension of the current COVID-19 Public Health Emergency (PHE)-related waiver which provides Medicare coverage for rehabilitation services provided by therapists and therapist assistants via telehealth.2 Without this legislation, the ability for outpatient rehabilitation therapists to provide real-time, face-to-face services via telehealth would have been cut off when the PHE lapsed. Instead, after the PHE expires, Medicare beneficiaries treated by private practice physical therapists, physical therapist assistants, occupational therapists, occupational therapy assistants, and speech language pathologists will receive an additional 151 days (approximately 5 months) of Medicare coverage for care provided to them via telehealth.
Public Health Emergencies are determined by the Secretary of the Department of Health and Human Services (HHS). Triggers for a PHE can range from a natural disaster, an outbreak of an infectious disease, or a disease or disorder such as the opioid crisis.3 By law, a PHE declaration is in force until the health emergency is over, but must be renewed if it is still needed after 90 days. If there is a need to extend the health emergency, the HHS Secretary is authorized to do so, but in 90-day increments.4
The current expiration date of the COVID-19 PHE is April 16, 2022.5 However, the Biden Administration has promised a 60-day notice if it doesn’t plan to renew this PHE and no such alert has been provided.6 Therefore, it is anticipated that the COVID-19 PHE will be renewed in April and likely be allowed to expire in mid-July. Should the PHE terminate this July, the 151 days extension of coverage of rehabilitation therapy provided via telehealth will expire in November 2022.
An additional legislative intervention is needed to ensure that private practice physical therapists can continue to provide care via telehealth after November 2022. Most Members of Congress have said they intend to preserve access to telehealth, and are considering longer-term legislative solutions. While there are a number of bills being considered, the Expanded Telehealth Access Act (S.3193/H.R.2168) would permanently add rehabilitation therapists and their assistants to the list of distant site providers that Medicare pays for telehealth.7 If you provide therapy services via telehealth, reach out to your lawmakers and ask them to cosponsor this crucial bill.
Note: Some waivers linked to the COVID-19 PHE will still expire when the PHE expires. Some, like the use of telehealth in rehabilitation therapy, have been singled out for an extension, while others – such as the ability of rehabilitation therapists in private practice settings to meet the direct supervision requirements using audio/visual telecommunications – will expire at the end of the year in which the PHE ends.
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1 Bill language available at: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiAlMXf-c32AhXzpnIEHQKgCiMQFnoECAYQAQ&url=https%3A%2F%2Frules.house.gov%2Fsites%2Fdemocrats.rules.house.gov%2Ffiles%2FBILLS-117HR2471SA-RCP-117-35.pdf&usg=AOvVaw3N-5SzalR5jHmEodD92gkX
2 Section 302. Expanding Practitioners Eligible to Furnish Telehealth Services