Advocacy Alert: Ask Congress to Extend a Critical Telehealth Policy for Hospices

The National Association for Home Care & Hospice (NAHC) is calling on home-based care advocates to reach out to your members of congress now and ask that, as part of any forthcoming omnibus government spending legislation, they include an extension of the COVID-related flexibility that is allowing hospices to perform the face-to-face (F2F) recertification via telehealth. We need your voices on this issue now, as it is expected that congress will pass an omnibus bill before the current stopgap funding measure expires next Friday, March 11, 2022.

Temporary expansions of some other pandemic telehealth flexibilities are being considered for an omnibus package, but the hospice F2F allowance is not currently a part of those discussions. Reach out and tell your lawmakers how critical this flexibility has been, and how it will continue to positively impact patients, families, and hospices if extended.

Use NAHC’s grassroots outreach campaign to send a note to your elected officials about this issue HERE.

NAHC recently joined other major national associations representing hospices to send a letter to key Congressional leaders, urging them to extend the F2F telehealth flexibility. The letter requests that Congress, as part of any broader legislative effort to expand COVID-related Medicare telehealth flexibilities beyond the end of the PHE, make sure to explicitly extend the waiver that is allowing hospices to perform the (F2F eligibility recertification via telehealth. Our hospice members have reported that being able to perform the F2F virtually has been a major success and should be permanently, or at least temporarily, expanded beyond the pandemic. Hospices are able to collect all necessary clinical information for recertification, follow patient and family wishes for fewer visits during the pandemic, and allocate staff more effectively due to this flexibility.

However, unlike many of the other pandemic telehealth flexibilities that are authorized in a blanket fashion under HHS’ expanded Section 1135 waiver authority, the hospice recertification flexibility is a separate, standalone statutory provision. Any future broad-based legislative extension of telehealth flexibilities implemented under the 1135 waiver authority would not address the hospice telehealth recertification allowance, so separate legislative action would help ensure this particular flexibility can be continued post-PHE. Importantly, a number of popular bipartisan and bicameral bills do call for a permanent extension of the hospice F2F telehealth flexibility, including the Connect for Health Act of 2021 (S.1512/H.R. 2903), the Telehealth Modernization Act (S. 378/H.R. 1332), and the CURES 2.0 Act (H.R. 6000).

NAHC believes that absent specific congressional action on extending the F2F flexibility, CMS itself does have authority on its own to keep the allowance in place after the PHE ends. In the 2020 Interim Final Rule (IFR) implementing various COVID-19 flexibilities, CMS stated, as rationale for its decision to implement the F2F telehealth flexibility, “The statute is silent as to whether a face-to-face encounter solely for the purpose of Medicare hospice recertification (meaning there is no direct patient care) could be conducted via telecommunications technology by the hospice physician or NP”. We will work hard to engage CMS on this issue in parallel to our congressional advocacy.

As we have done throughout the pandemic, NAHC will continue to work with both Congress and CMS to ensure COVID’s lessons-learned and best-practices are institutionalized into policy that supports home-based care providers across the country.