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Senate Impasse Puts Medicare Telehealth Flexibilities at Risk of Weekend Lapse

A DHS funding dispute has stalled a House-passed extension, prompting providers to prepare for a short-term disruption.

Overview

  • The House approved H.R. 7148 on Jan. 22 to extend Medicare telehealth flexibilities through Dec. 31, 2027 and renew the hospital-at-home waiver for five years, but the bill still requires Senate passage and the president’s signature.
  • Senate disagreements over Department of Homeland Security funding have delayed the package, and even a vote today would not avert a brief lapse because the House is not scheduled to reconvene until Monday.
  • If the waivers expire, Medicare reverts to pre-pandemic rules that restrict telehealth largely to rural patients at approved originating sites, narrow the list of eligible practitioners, and sharply limit audio‑only services.
  • During the late‑2025 lapse, CMS instructed Medicare Administrative Contractors to hold or return telehealth claims and later allowed resubmission, offering a playbook for providers to track services and manage billing during any short gap.
  • The Acute Hospital Care at Home program would also lapse, affecting 373 organizations in 37 states and requiring hospital‑at‑home patients to return to brick‑and‑mortar facilities until authority is restored.