The Telehealth Coverage Act of 2025 makes permanent Medicare telehealth flexibilities that were temporarily expanded during the pandemic. It eliminates in-person visit requirements for mental health services, substance use disorder treatment, home dialysis visits, and stroke care, allowing these to be provided via telehealth. The bill also expands who can provide telehealth services, extends coverage for rural health clinics and community health centers, and requires new billing modifiers for certain telehealth claims by January 2026. Additionally, it includes guidance to help providers serve patients with limited English proficiency through telehealth and expands access to virtual diabetes prevention programs. These changes primarily affect Medicare beneficiaries, healthcare providers, and telehealth technology companies.
The Improving Veteran Access to Care Act (HR 6038) requires the Department of Veterans Affairs (VA) to create and implement a plan to modernize health care appointment scheduling for veterans. The plan must include a new scheduling system allowing veterans to view and book appointments online (for primary, mental health, and specialty care), a self-service platform for booking or requesting referrals, and phone-based scheduling assistance. The VA must submit the plan to Congress within one year of enactment, fully implement it within two years, and provide annual progress reports detailing costs, metrics, and challenges. This bill directly affects veterans seeking VA health care and VA staff managing scheduling operations, focusing on concrete improvements to access and efficiency.
This bill creates a federal grant program to expand mental health and substance use care for rural underserved populations, specifically targeting health professional shortage areas and individuals working in farming, fishing, or forestry. It authorizes $10 million annually (2025-2029) for eligible providers to deliver home-based telemental health services - using video or phone - directly to patients' homes or comfortable settings. Grantees must develop quality metrics comparing remote care to in-person services, expand broadband access, provide patient devices, and cover provider technology costs. The program requires annual reports to Congress on service impact and quality.
The Audio-Only Telehealth Access Act of 2025 would require Medicare to cover and pay for telehealth visits conducted over the phone (audio-only), not requiring video, during the emergency period defined in the Social Security Act. This change would directly affect Medicare beneficiaries - particularly older adults or those in rural areas with limited internet access - and healthcare providers who offer telehealth services. The bill amends Section 1834(m)(9) of the Social Security Act to include audio-only visits under existing Medicare coverage rules, ensuring providers receive reimbursement at the same rate as video telehealth. It expands access to care by removing the need for video technology during the specified emergency period.
This bill creates a pathway for Medicare to cover innovative medical devices earlier. It allows "breakthrough devices" (new technologies designated for expedited FDA review) to qualify for Medicare's "new technology add-on payment" if approved, cleared, or authorized by the FDA before July 1 of a fiscal year. This means Medicare beneficiaries gain faster access to these new devices, and hospitals receive additional payment for using them, effective in the first quarter after FDA approval. The provision applies to devices approved on or after July 1, 2023, and is designed to be budget-neutral.
HR 3467 reforms Medicare Advantage (MA) by requiring most plans to use fixed payments per member (capitated payments) starting in 2028, with exceptions for existing plans and special needs plans. It modifies payments by reducing blended benchmarks, changing how health status risk adjustments are calculated (using only face-to-face/telehealth diagnoses), and eliminating quality-based payment increases. The bill mandates automatic enrollment into the lowest-premium MA plan for eligible beneficiaries starting in 2028, with a 3-year enrollment lock-in period unless a hardship event occurs. Additionally, it requires MA plans to include hospice care coverage (with a 2028 transition exception) and adds an exception for durable medical equipment and Part D drugs under the Stark Law.
The Mental Health TALK SAFE Act of 2026 amends the Controlled Substances Act to allow telehealth prescribing of certain controlled substances for mental health treatment. It establishes requirements for telehealth entities that prescribe these substances, including minimum staffing standards (like employing at least 250 psychiatrists working 30+ hours weekly), mandatory compliance officers, and restrictions on practitioner compensation structures. The bill prohibits pharmacists from refusing to fill prescriptions issued via telehealth based solely on the method of evaluation, requiring them to attempt validation through communication with the patient or prescriber first. It affects telehealth entities, psychiatrists, and psychiatric-mental health advanced practice nurses providing remote mental health care services. The legislation preempts state laws that would restrict these telehealth prescribing practices for mental health conditions.
S 825 requires the Justice Department to develop a report within 150 days on programs providing evidence-based mental health care for public safety officers, including police, firefighters, EMTs, and 911 dispatchers. The report must outline how to deliver trauma-informed care, peer support, and family services through in-person or telehealth options, while ensuring confidentiality for officers seeking help. It also needs to detail administrative efficiency across states and territories, draft necessary grant conditions, and estimate annual funding needs. This bill does not fund programs but sets a framework for future action based on the high rates of PTSD and suicide among these frontline workers.
The Rural Health Focus Act (S 403) creates a new Office of Rural Health within the CDC, headed by a director appointed by the CDC Director. This office will directly serve rural communities by coordinating CDC research on rural health challenges, developing policies to improve care (including telehealth), and awarding grants to support rural health initiatives. Key mechanisms include acting as the CDC’s main contact for rural health issues, identifying healthcare disparities in rural areas, and collaborating with other federal health offices to avoid duplication. The bill aims to address specific health access and outcomes gaps faced by people living in rural populations through targeted federal coordination and support.
This bill requires the Department of Veterans Affairs (VA) to commission an independent study comparing the quality of mental health and addiction therapy care provided by VA health care providers versus non-VA providers. The study must assess key factors like health outcome improvements, use of evidence-based practices, coordination between providers, veteran satisfaction, and care for veterans with co-occurring conditions. It will cover various treatment settings - including telehealth, inpatient, and outpatient care - and must be completed within 18 months, with results published publicly. The study directly affects veterans receiving mental health or addiction therapy services through VA or non-VA providers. The bill does not change benefits or funding but aims to gather data to inform future care decisions.
