New Bill Aims to Extend Acute Hospital Care at Home Waiver

Sens. Tom Carper (D-Delaware) and Tim Scott (R-South Carolina) introduced a bill called the Hospital Inpatient Services Act that allows for a two-year extension of the federal acute hospital-at-home waiver.

The Acute Hospital Care at Home waiver was introduced in November 2020 by the Centers for Medicare and Medicaid Services. The goal of the waiver was to allow treatment for common acute conditions to take place in home settings.

The program has been widely used during the pandemic, with 92 health systems, comprising 203 hospitals across 34 states, participating as of March 4.

The bill extends the waiver for two years after the COVID-19 public health emergency has ended and requires CMS to issue regulations that provide health and safety requirements for the approved hospital-at-home programs within one year of the bill being enacted into law.

The bill also requires the secretary of Health and Human Services to conduct research on the waiver that could lead to permanent adjustments to at-home services for Medicare patients.

The last several years have shown that providers and patients alike view care from home programs as beneficial.

“By extending these flexibilities, Congress will create a predictable pathway for medical professionals to fully realize advances in the care delivery system that enable patients to be treated with safe, equitable, person-centered care in the comfort of their own homes.” said Stephen Parodi, MD, executive vice president of the Permanente Federation at Kaiser Permanente, in a press release from Advanced Care at Home Coalition.

The coalition, created by Mayo Clinic, Medically Home and Kaiser Permanente, launched last year. It includes several other prominent healthcare organizations like Geisinger Health and Johns Hopkins Medicine.

During the COVID-19 pandemic, state and federal agencies removed barriers restricting telehealth use. This was largely due to limited access to in-person care and the belief that telehealth would enhance communication between providers and patients.

In addition to the Hospital Inpatients Services Act, the anticipated end of flexibilities enacted during the COVID-19 pandemic has produced various other bills seeking to extend telehealth services.

In February, US Sens. Catherine Cortez Masto (D-Nevada) and Todd Young (R-Indiana) introduced the Telehealth Extension and Evaluation Act. This bill allows CMS to continue Medicare payments for telehealth services.

Similarly, US representatives created a bill known as the Telehealth Extension Act in December 2021. The representatives included Lloyd Doggett (D-Texas), chair of the House Ways & Means Health Subcommittee, Devin Nunes (R-California), Health Subcommittee ranking member, and Health Subcommittee members Mike Thompson (D-California), Mike Kelly (R-Pennsylvania), and David Schweikert (R-Arizona). The bill solidifies permanent telehealth access and abolishes any patient access restrictions based on geographic location.

The CONNECT for Health Act introduced by a group of senators and representatives had similar goals. The bill intends to promote telehealth use and remote patient monitoring within Medicare.