This bill, titled the Telehealth Modernization Act, significantly extends several key Medicare telehealth flexibilities until September 30, 2027. These extensions include the continued removal of geographic requirements and the expansion of originating sites for telehealth services. It also broadens the types of practitioners eligible to furnish telehealth services and allows for the continued provision of audio-only telehealth services under Medicare.

The legislation further delays the implementation of in-person requirements for mental health services furnished through telehealth and telecommunications technology until October 1, 2027. For Federally Qualified Health Centers and Rural Health Clinics, the bill extends telehealth services and establishes new payment rules for fiscal years 2026 and 2027. It also extends the use of telehealth for face-to-face encounters prior to hospice care recertification, with new exceptions for high-risk providers or areas, and requires a specific modifier on claims for these telehealth encounters starting January 1, 2026.

A major provision extends the Acute Hospital Care at Home waiver flexibilities until 2030, allowing hospitals to continue providing acute-level care in patients' homes. This extension is coupled with a requirement for the Secretary of Health and Human Services to conduct a comprehensive study by September 30, 2028. This study will analyze the program's criteria, quality of care, health outcomes, costs, and patient demographics, while also accounting for selection bias.

To enhance program integrity, the bill introduces measures for Durable Medical Equipment (DME), requiring items with aberrant billing patterns to be added to a Master List for potential prepayment review starting January 1, 2028. It also mandates a report from the Inspector General by January 1, 2026, assessing fraud risks related to clinical diagnostic laboratory tests and proposing effective mitigation strategies.

Finally, the bill requires the Secretary of Health and Human Services to issue guidance within one year on best practices for furnishing telehealth services to individuals with limited English proficiency. It also introduces flexibilities for in-home cardiopulmonary rehabilitation services and mandates the inclusion of virtual Diabetes Prevention Program suppliers in the Medicare Diabetes Prevention Program expanded model from 2026 to 2030, removing limits on individual enrollment.