Telehealth on a Ticking Clock: What You Need to Know

With fewer than 60 days until expiration, critical telehealth and hospital-at-home flexibilities granted under the COVID-19 public health emergency are at risk of vanishing. If Congress fails to pass a healthcare extender package by June, the rollback could disrupt care for millions of Medicare beneficiaries and place dozens of digital health platforms in limbo.

The looming cliff is creating deep uncertainty across the healthcare IT ecosystem—from rural hospitals to employer plan sponsors, from remote patient monitoring vendors to large telemedicine networks. Despite bipartisan support for a two-year extension, shifting political dynamics in Washington have delayed a final deal.

What’s at Stake

The flexibilities, originally enacted in 2020, expanded telehealth access under Centers for Medicare & Medicaid Services (CMS) waivers. These included:

Allowing Medicare patients to receive telehealth services from home, regardless of geography
Expanding the list of eligible provider types and services
Permitting hospital-level care at home under the Acute Hospital Care At Home (AHCAH) program
Temporarily enabling first-dollar telehealth coverage in high-deductible health plans tied to HSAs

These provisions are scheduled to expire on June 30, 2025, after an emergency three-month extension was passed in March. Their potential lapse would mark the first major contraction of virtual care access since the pandemic began.

Providers and Vendors Brace for Impact

Many digital health leaders argue that failing to extend these waivers will damage care continuity, especially for rural and chronically ill populations. The American Telemedicine Association (ATA) and Alliance for Connected Care have led lobbying efforts on Capitol Hill, warning that CMS’s infrastructure—and patient habits—have already shifted permanently.

“This isn’t just a pandemic workaround anymore—it’s a core part of modern care delivery,” said Kyle Zebley, senior vice president at the ATA, in an April 2025 interview with Fierce Healthcare.

Home-based care platforms like Contessa Health and Medically Home are particularly exposed. Both operate under the AHCAH waiver, which has enabled hospitals to admit acute patients for at-home monitoring and treatment—significantly expanding hospital capacity and lowering per-case costs.

“If the AHCAH authority expires, we’ll have to pause new admissions, furlough staff, and renegotiate contracts mid-year,” said Ami Patel, COO at Medically Home. “This is not just a regulatory issue. It’s an operational shock.”

Employer Plans Caught in the Middle

The expiration also threatens popular telehealth benefits for employer-sponsored health plans. During the pandemic, regulators allowed high-deductible health plans (HDHPs) to cover virtual visits before employees met their deductible. That flexibility enabled broader access without jeopardizing Health Savings Account (HSA) eligibility.

Without renewal, plan sponsors will face tough choices: remove the benefit, risk non-compliance, or design cost-sharing workarounds.

“This is one of the most utilized benefits we offer,” said Amanda Koh, benefits director at Hewlett Packard Enterprise. “Losing it would not only confuse our members—it would increase avoidable ER visits and downstream costs.”

Groups like the Purchaser Business Group on Health (PBGH) and HR Policy Association are advocating for permanent authorization of telehealth flexibility for HDHPs and seasonal workers.

Tech Vendors Caught in Legislative Uncertainty

From EHR integration to remote prescribing, many digital health vendors have spent years optimizing for a reimbursement environment that may now be reversed.

Remote monitoring providers like Validic and BioReference Health are pressing CMS to adopt new CPT codes that reflect updated usage patterns and hybrid care models. Several are also lobbying to reduce the minimum number of days required for device data billing, currently set at 16.

“We’re innovating based on rules that might disappear in a matter of weeks,” said Drew Schiller, CEO of Validic. “We need stability to drive real adoption.”

AI, Privacy, and Licensing Still in Play

In parallel, states are advancing their own policies on AI-driven telehealth tools, mental health chatbots, and prescribing rules—raising compliance complexity for multi-state platforms. Meanwhile, advocates are still pushing Congress to clarify rules on remote prescribing of Schedule II controlled substances, which remain governed by Biden-era waivers set to expire at year’s end.

The Connected Health Initiative is also asking CMS to stop requiring clinicians to list their home address on Medicare forms, citing privacy and safety risks for virtual-only providers.

What Happens Next?

Congress is expected to revisit telehealth legislation as part of a broader summer appropriations package. However, given the Trump administration’s pivot toward entitlement reform and deficit reduction, a standalone extension is unlikely.

Sources close to the House Ways and Means Committee say a temporary one-year renewal is the most likely outcome—delaying, but not solving, the larger policy debate.

For now, healthcare IT teams must prepare for either outcome: a last-minute extension, or the start of a regulatory reset. That means scenario modeling, claims system adjustments, and patient communications are all on deck.

Because when the countdown hits zero, policy ambiguity won’t be an excuse for non-compliance—or lost revenue.

Sources:

Telehealth on a Ticking Clock: What Happens If Congress Lets Medicare Flexibilities Expire?