Medicare Plans to End Most Telehealth Coverage Soon

By Crystal Lindell

Telehealth access was greatly expanded during the COVID-19 pandemic, but that expansion is slated to end this month for many older patients. Medicare is planning to end most coverage for telehealth appointments as of January 31, 2026.

There are some exceptions to the new policy. Telehealth appointments for those living in a rural area or seeking care in a rural area will still be covered. So will appointments for monthly home dialysis for end-stage renal disease; appointments for acute stroke; and appointments for behavioral health disorders.

The new policy only applies to Original Medicare plans. Medicare Advantage Plans may still cover telehealth appointments.

It’s baffling that this type of policy is being implemented for Medicare patients at all, seeing as how most people on Medicare are senior citizens — a demographic that is more likely to have mobility issues as well as a higher risk of falls.

The American Medical Association is calling on the federal government to make telehealth coverage permanent ahead of this month’s deadline. Congress has repeatedly extended the telehealth flexibilities for Medicare patients, but often at the last moment. The AMA says the constant procrastination creates uncertainty for millions of patients and their physicians.

“As the current waiver deadline approaches, Congress must finally act decisively to prevent a disruptive and abrupt halt to the expanded telehealth services that have improved care continuity, chronic disease management, and access for rural and underserved communities,” said AMA President Bobby Mukkamala, MD.

The AMA says telehealth offers the potential for long-term savings through early medical intervention, improved chronic disease management, and reduced use of expensive emergency care and inpatient services. Telehealth also has higher appointment completion rates and reduces hospital readmissions. In short, it helps our complex healthcare system work more efficiently and at a lower cost. 

“Now is the time for lawmakers to secure innovation, modernize care delivery, and protect access to telehealth for all Medicare beneficiaries by passing comprehensive, forward-looking reform,” the AMA said.

Speaking from personal experience, I am reminded of the time my grandma fell on the ice in front of her home a few years ago and broke her hip. The injury led to a months-long recovery process that included an extended stay at a rehabilitation facility. Aside from how inconvenient the entire episode was, it was also an extremely painful injury for her to endure.

Today, we limit how often she leaves the house to reduce the risk of her falling again. And we are especially cautious whenever the temperatures drop low enough to create icy patches on the ground.

Thus, whenever possible, we opt for telehealth appointments to keep grandma safe. Aside from reducing her fall risk, they also lower the risk of her being exposed to viruses at an in-person doctor’s office.

It seems like common sense that seniors in particular would have easy access to telehealth services, and my hope is that Congress will act and extend that access before the deadline. 

Drug Overdose Rates Rise in Rural Areas

By Pat Anson, Editor

Rates of drug overdose deaths in rural areas of the United States now exceed those in urban areas, according to a new report by the Centers for Disease Control and Prevention.

CDC researchers say the overdose rate in non-metropolitan (rural) areas was 17 deaths per 100,000 people in 2015, which was slightly higher than urban areas (16.2 deaths). Both rates are substantially higher than they were a generation ago. About 52,000 Americans died of drug overdoses in 2015.

“The drug overdose death rate in rural areas is higher than in urban areas,” said CDC Director Brenda Fitzgerald, MD. “We need to understand why this is happening so that our work with states and communities can help stop illicit drug use and overdose deaths in America.”

In 2015, both urban and rural areas experienced significant increases in the percentage of people aged 26 and older who reported illicit drug use in the past month.

One of the few bright spots in the CDC report is that use of illicit drugs by adolescents (aged 12-17 years) has declined for the last ten years.

The report did not go into detail on what drugs were being abused, although it acknowledges the declining role of prescription opioids in the overdose crisis.

“Although prescription drugs were primarily responsible for the rapid expansion of this large and growing public health crisis, illicit drugs (heroin, illicit fentanyl, cocaine, and methamphetamines) now are contributing substantially to the problem,” the report found.

“Recent studies suggest that a leveling off and decline has occurred in opioid prescribing rates since 2012 and in high-dose prescribing rates since 2009.”

Curiously, while those studies have documented the increased role of heroin, illicit fentanyl and other illegal opioids in the overdose crisis, the federal government’s public awareness campaigns remain focused on prescription opioids.  

Heroin and fentanyl are barely even mentioned in the Department of Health and Human Services’ “5-Point Strategy to Combat the Opioid Crisis.” The strategy focuses instead on “advancing better practices for pain management,” and increasing access to addiction treatment and overdose prevention drugs.

The CDC also recently launched an advertising campaign using billboards and videos that completely ignore the scourge of heroin and fentanyl.  The CDC explained the omission by saying it wanted to focus on prescription opioids and avoid “diluting the campaign messaging.”

“Prescription opioids can be addictive and dangerous,” a woman says in one CDC ad.

“One prescription can be all it takes to lose everything,” a man says in another ad.

Five public health experts interviewed by Pacific Standard questioned whether the CDC campaign will be effective, because the ads don't empower people or give them an alternative to prescription opioids.

"The campaign isn't going to make a damn bit of difference," said Bill DeJong, a professor of community health sciences at Boston University.