Telehealth Modernization Act
- Bill Number
- H.R. 5081
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-09-02: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-06-11T18:31:24Z
AI-Generated Summary
Purpose This legislation, titled the Telehealth Modernization Act, amends title XVIII of the Social Security Act (Medicare) to extend temporary flexibilities for telehealth services, acute hospital care at home, and related programs that were originally expanded during the COVID-19 public health emergency. It aims to maintain broader access to remote care while adding program integrity safeguards and equity measures.
Key Provisions
- Telehealth Extensions: Extends removal of geographic restrictions, expansion of originating sites, eligibility for additional practitioners, services at Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), audio-only services, and mental health telehealth flexibilities through September 30, 2027.
- Hospice Care: Extends the option for telehealth face-to-face encounters prior to hospice recertification through September 30, 2027, with exceptions for certain high-risk providers; requires specific modifiers or codes on claims starting January 1, 2026.
- Acute Hospital Care at Home: Extends the waiver flexibilities through 2030 and mandates a follow-up study and report by September 30, 2028, comparing quality, costs, outcomes, and patient demographics between home-based and traditional inpatient care.
- Durable Medical Equipment (DME) and Laboratory Integrity: Adds items with aberrant billing patterns (e.g., orders from new providers) to the Master List for potential prepayment review starting 2028; requires an Inspector General report by January 1, 2026, on fraud risks in clinical diagnostic laboratory tests.
- Limited English Proficiency (LEP) Guidance: Directs the Secretary of Health and Human Services to issue best practices within one year on interpreters, accessible instructions, digital portals, and multilingual materials for telehealth.
- Cardiopulmonary Rehabilitation and Diabetes Prevention: Allows in-home audio-video services through 2026–2027 and permits virtual-only Medicare Diabetes Prevention Program (MDPP) suppliers through 2030, with no enrollment limits.
Significant Changes to Existing Law
- Replaces the September 30, 2025, expiration dates in multiple sections of the Social Security Act (e.g., 1834(m), 1814(a)(7)) with September 30, 2027, or later dates.
- Introduces new payment rules for FQHC/RHC telehealth services in fiscal years 2026–2027 under prospective payment systems.
- Adds a requirement for claim modifiers in hospice telehealth encounters and expands the Master List criteria for DME review.
- Mandates a second study on the Acute Hospital Care at Home initiative and formal guidance on serving LEP individuals.
Potential Impacts
- On Citizens: Increases access to telehealth for rural, homebound, and mental health patients, as well as those with limited English proficiency, potentially reducing travel barriers and improving continuity of care.
- On Government Agencies: Extends Medicare payment flexibilities, which may affect program spending; requires new studies, reports, and guidance from the Department of Health and Human Services and the Inspector General.
- On International Relations: No direct provisions or impacts identified in the legislation.
Main Stakeholders Affected
- Medicare beneficiaries, particularly those in rural areas, with mental health needs, or limited English proficiency.
- Healthcare providers, including physicians, hospitals, FQHCs, RHCs, and hospice programs.
- Suppliers of durable medical equipment, laboratory services, and telehealth technology.
- Medicare Diabetes Prevention Program participants and virtual service providers.
Notable Legal, Constitutional, or Political Implications The bill continues temporary authorities originally authorized under public health emergency declarations without altering core Medicare statutory frameworks or raising apparent constitutional issues. It emphasizes program integrity through billing reviews and data analysis, while promoting equitable access; implementation relies on existing regulatory authority rather than new mandates.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Carter, Earl L. "Buddy" [R-GA-1]
Cosponsors (7)
Rep. Dingell, Debbie [D-MI-6], Rep. Ross, Deborah K. [D-NC-2], Rep. Lynch, Stephen F. [D-MA-8], Rep. Liccardo, Sam T. [D-CA-16], Rep. Johnson, Julie [D-TX-32], Rep. Riley, Josh [D-NY-19], Rep. Conaway, Herbert C. [D-NJ-3]
Recent Actions
- 2025-09-02: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-09-02: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-09-02: Introduced in House
- 2025-09-02: Introduced in House
Bill Versions
- Telehealth Modernization Act — issued 2025-09-02 — PDF (20 pages)