A bipartisan bill in the U.S. House of Representatives would protect Medicare patients’ access to telehealth services in advance of when payment and regulatory flexibilities that enable physician practice and health systems to offer this kind of care are set to expire on Sept. 30.
“We can’t afford not to do this,” said David Newman, MD, chief medical officer of virtual care at Sanford Health, about the permanent protection of telehealth services. “In rural America, it’s often telemedicine or no medicine at all.”
South Dakota-based Sanford Health is the largest rural health system in the U.S., serving more than 2 million patients a year in a largely rural spread of 250,000 square miles. Their data shows that on average, virtual care saves their patients 176 travel miles round trip. Two-thirds of Sanford Health patients who've used virtual care in the last year live in a rural community at least 30 miles from a major medical center.
Sanford Health is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians, and care teams with resources to help drive the future of medicine.
The AMA strongly supports the telehealth bill in Congress, H.R. 4206, also called the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2025. The legislation was introduced by Reps. Mike Thompson (D-Calif.), David Schweikert (R-Ariz.), Doris Matsui (D-Calif.) and Troy Balderson (R-Ohio).
The bill would put into law many of the temporary measures permitted at the onset of the COVID-19 public health emergency that let Medicare recipients access telemedicine services in their homes and would also let them continue to use vital telemental health services without requiring in-person visits.
“Telehealth is essential to preserving patient access to physicians and promotes greater utilization of innovative technologies that will only advance the future of health care,” AMA CEO and Executive Vice President John J. Whyte, MD, MPH, wrote in a letter to the representatives (PDF).
Solid protections needed
The bill before the House would permanently remove the geographical restrictions for telehealth services, allow Medicare patients to have telehealth visits wherever their audio or video connections are available and repeal a requirement, from the Consolidated Appropriations Act of 2021, that Medicare patients have an in-person visit with a physician within six months of an initial telemental health visit.
The companion bill, S. 1261, already has attained 63 bipartisan co-sponsors.
Extensions of the flexibilities have been approved over the previous five years, but no permanent change has been enacted. And although the most recent continuing resolution passed by Congress to fund the government through the 2025 fiscal year continues the rule easing, that extension expires Sept. 30.
From AI implementation to EHR adoption and usability, the AMA is fighting to make technology work for physicians, ensuring that it is an asset to doctors.
Don’t go back on telehealth
Before restrictions were eased in the wake of the COVID-19 public health emergency, patients relying on Medicare had little access to telemedicine and none in the convenience of their homes. The original rules required that Medicare beneficiaries live in an approved rural area to use telehealth services, and patients had to travel to an acceptable “originating site” for their appointments, negating most of the benefits of telemedicine.
There are several reasons why it may be difficult for patients to travel to physician offices for appointments. These include long travel times, lack of transportation or child care, physical limitations and the need for a caregiver to accompany the patient.
In an interview with the AMA, Dr. Newman, an endocrinologist, said that telehealth has enabled physicians at Sanford Health “to provide lots of services to rural America that they wouldn't be able to get otherwise—some specialty services, primary care, mental health—and we can deliver all of this to either the patient's home or to a clinic in rural America.”
The payment regulatory flexibilities have “allowed us to increase quality, increase access and give our providers flexibility, and all of this would have to be reset if the waivers go away,” he said.
Sanford Health offers virtual care in 78 specialties across 93 locations in the Upper Midwest.
Patients, physicians agree on telehealth need
After temporary legislation was passed at the onset of the COVID-19 pandemic, all Medicare patients could get telehealth services if offered by their physicians. That improved access for patients, particularly those in rural and areas underserved by limited access to health care. Patients were also able to take part in audio-only visits if they had no or unreliable video connections.
At Sanford Health, one in five behavioral health appointments is a virtual visit. And in the last 10 years, their data shows they’ve provided almost a million virtual consults, resulting in more than 51.2 million fewer miles of driving for patients.
“It would dramatically make our patients and our providers suffer if the if the waivers go away,” Dr. Newman said.
A survey shows that 74% of physicians report working in practices that offer telehealth, a threefold increase over pre-pandemic figures.
“Permanently extending telehealth coverage will benefit patients and physicians far and wide, ushering in a new era of patient care,” AMA President Bobby Mukkamala, MD, said in a bipartisan news release that was issued by Rep. Thompson’s office to announce the measure. “Medicare coverage of telehealth offers better access to health care not just for rural and underserved communities; it also reduces travel time and serves as a vital tool for patients to receive seamless care with their existing physicians.”
Dr. Newman said that patients, physicians and health systems need certainty on this issue to advance care. Telehealth, he said, has proven its value, especially for rural patients who too often have no other way to get the care they need.
“There is bipartisan support. The question is: When is this just going to be permanent? When can we integrate this into our lives without having to worry about it being covered?”
Learn more with the AMA about seven ways that telehealth is reshaping medicine for the better.
In a Leadership Viewpoints column, AMA Immediate Past President Jesse M. Ehrenfeld, MD, MPH, explained how permanently expanding telehealth access will improve public health.
Visit AMA Advocacy in Action to find out what’s at stake in supporting telehealth and other advocacy priorities the AMA is actively working on.
Fighting for Physicians
Get updates on how the AMA is fighting for physicians on critical issues—delivered to your inbox.
