March 23, 2020

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***Update*** This issue was fixed in the Coronavirus Aid, Relief, and Economic Security Act, signed by the President on March 27, 2020. Thanks to all who advocated for fair treatment for our partners in Rural Health Clinics and Federally Qualified Health Centers and their patients.  


The Medicare telehealth expansion in the recent emergency funding bill is welcome news for patients and practitioners. Remote office visits will be much more widely available for the duration of the national COVID-19 public health emergency. This is an important tool to minimize further spread of the disease, protecting both patients and providers. Unfortunately, an oversight in this legislation leaves out some of the most vulnerable populations in rural communities. We are encouraged to see the Senate include a fix in their bill that may become law soon. 

Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), more than 6,000 facilities in historically underserved areas, will not be able to provide remote office visits to their Medicare patients unless Congress acts. We urge the Congress to act quickly to add RHCs and FQHCs to the list of eligible providers, as the health crisis is accelerating each day. The one in five Americans who reside in rural areas deserve the same access to care as everyone else, delivered as safely as possible.   

How Did Congress Leave out These Rural Providers? 

Before the public health emergency, telehealth services were available mostly to rural patients. A rural Medicare patient could travel to a local health facility, called an “originating site,” such as their doctor’s office, a rural health clinic, or hospital. At the local facility, the patient would be connected through real time telecommunications technology to a provider at a separate location, called a “distant site.” This allowed rural beneficiaries access to a wider range of providers, including specialists who were not available locally.   

The emergency legislation expanded these services to Medicare patients living outside rural areas. It also expanded the definition of “originating site” to include the homes of patients for the duration of the public health emergency. However, the law did not change the definition of distant site to include RHCs and FQHCs. Unless Congress changes the law, rural Medicare patients can receive services at their homes, but they won’t be able to connect with RHCs and FQHCs remotely, even if that is where they get their regular care.  

To learn more about telehealth options for Medicare, join Caravan Health for a webinar with our Chief Medical Office, Dr. Anna Loengard on Thursday, March 26 at 9 AM PT/12 PM ET. Register for the webinar here.  

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