As the NCAA March Madness tournaments heat up, lawmakers and the Trump administration are making their own plays on key federal telehealth policy issues. On March 15, the President signed the Full-Year Continuing Appropriations and Extensions Act, 2025 (“Continuing Resolution”) to fund the federal government through September 30. The Continuing Resolution extends several key virtual care payment policies just weeks before the pandemic-era telehealth flexibilities were set to expire. Additionally, on March 20, the Drug Enforcement Administration (“DEA”) and the U.S. Department of Health and Human Services (“HHS,” and together with the DEA, the “Agencies”) announced a delay in implementation of the final rule establishing special requirements for prescribing buprenorphine to treat Opioid Use Disorder (“OUD”) via telemedicine until December 31, 2025.
Extension of Medicare Telehealth Coverage Flexibilities and Medicare Acute Hospital at Home Coverage
Medicare telehealth flexibilities were originally adopted in response to the COVID-19 Public Health Emergency (“PHE”). In December 2024, Congress passed another extension through March 31, 2025. The Continuing Resolution now extends these flexibilities through September 30, 2025. As a result of the Continuing Resolution:
- Medicare beneficiaries will be able to continue accessing telehealth services in any geographic area in the United States, rather than only in rural areas.
- Medicare beneficiaries will be able to continue accessing virtual care from their homes for telehealth visits that Medicare pays for, rather than being required to travel to a health care facility.
- Certain Medicare telehealth visits can continue to be delivered using audio-only technology (such as a telephone) if the patient is unable to use both audio and video, such as a smartphone or computer.
The Acute Hospital Care at Home (“AHCAH”) program was also extended through September 30, 2025. The AHCAH program was authorized by the Centers for Medicare & Medicaid Services to cover more than sixty conditions, including asthma, chronic obstructive pulmonary disease, pneumonia and other conditions that can be safely managed in the patient’s home during the PHE.
Buprenorphine Telemedicine Prescribing Final Rule Delayed
The Agencies published the final rule on buprenorphine telemedicine prescribing, titled Expansion of Buprenorphine Treatment via Telemedicine Encounter (the “Buprenorphine Prescribing Rule”), in the final days of the Biden Administration, with an original effective date of February 18, 2025. That rule finalized a policy that would permit DEA-registered practitioners to use audio-only telemedicine interactions to prescribe up to a six-month supply of buprenorphine to treat OUD, without having conducted an in-person medical evaluation. However, consistent with the White House’s Regulatory Freeze Memorandum, the Agencies subsequently delayed the Buprenorphine Prescribing Rule’s effective date to March 21, 2025, in order to allow interested parties to provide comments about issues of fact, law and policy raised by the rule, and to allow the Agencies further opportunity to review any potential questions of fact, law and policy raised by the rule.
Since the Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications permits practitioners to prescribe via telemedicine through December 31, 2025, the Agencies have postponed the Buprenorphine Prescribing Rule’s effective date again to align with the expiration of those flexibilities and to provide additional time to continue evaluating the merits of this remote prescribing policy. This means that DEA-registered practitioners will continue to be permitted to issue prescriptions for controlled medications (including prescriptions for buprenorphine) to patients for whom they have not conducted an in-person medical evaluation, provided:
- The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of their professional practice;
- The telemedicine communication is conducted using an audio-visual (or audio-only, in the case of buprenorphine prescriptions for OUD), real-time, two-way interactive communications system; and
- The practitioner is acting in accordance with applicable federal and state law.
Practical Takeaways
- The extension of the Medicare telehealth flexibilities and the delay of the Buprenorphine Prescribing Rule maintain the status quo. This means that, for now, providers and patients can breathe a little easier knowing that the pandemic-era treatment modalities that many have come to rely on will remain intact.
- Given the short-term nature of the extensions until the end of FY 2025, Congress will need to work in the 119th Congress to explore further extensions and/or more permanent legislation addressing telehealth.
- It is critical that virtual care stakeholders continue to monitor legislative and regulatory efforts to address Medicare coverage and reimbursement for telehealth services, as well as the DEA’s rules to address controlled substance prescriptions through telemedicine. Stakeholders continue to lobby extensively to change fundamental portions of this rule.
- Given the interplay between the Buprenorphine Prescribing Rule and the broader controlled substance remote prescribing framework, we anticipate that any further efforts undertaken by the Agencies to implement or revise the Buprenorphine Prescribing Rule may additionally involve the DEA’s Telemedicine Special Registration proposal. Whether that will involve modifications to or rescission of these rules is still to be seen. But one way or the other, such efforts will likely have a significant impact on the provision of virtual care services.
If you have questions or would like additional information about virtual care, please contact:
- Chris Eades at (317) 977-1460 or ceades@hallrender.com;
- John Williams III at (202) 370-9585 or jwilliams@hallrender.com;
- Regan Tankersley at (317) 977-1445 or rtankersley@hallrender.com;
- Mayo Alao at (317) 977-1480 or malao@hallrender.com;
- Abigail Kaericher at (202) 742-9674 or akaericher@hallrender.com; or
- Your primary Hall Render contact.
Special thanks to Tori Kelly, Summer Associate, for her assistance in preparing this alert.
Hall Render blog posts and articles are intended for informational purposes only. For ethical reasons, Hall Render attorneys cannot—outside of an attorney-client relationship—answer specific questions that would be legal advice.
