The CONNECT for Health Act of 2025 amends Title XVIII of the Social Security Act to make many of the pandemic-era telehealth flexibilities permanent and to add new program integrity, data, and quality requirements. It targets statutory removal of geographic and originating-site barriers, expands the Secretary’s authority to broaden eligible telehealth practitioners, and changes payment treatment for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).
Beyond coverage changes, the bill creates enforcement and oversight mechanisms (including new OIG funding and an outlier-billing identification program), directs beneficiary and provider education, requires quality-measurement workstreams that incorporate telehealth, and mandates public reporting by CMS. If enacted, the bill would shift telehealth from temporary waiver status toward a durable, administrable part of Medicare delivery — with trade-offs for CMS administration, provider billing practices, and program spending to watch closely.
At a Glance
What It Does
The bill revises Medicare telehealth law in title XVIII: it removes certain geographic and originating-site restrictions, authorizes the Secretary to waive limits on which practitioners may furnish telehealth, and deems telehealth provided by FQHCs and RHCs to be payable under their payment systems. It also adds fraud-and-abuse clarifications for devices and technologies furnished to beneficiaries, establishes an outlier-billing identification and notification process, and requires new transparency, training, and quality-measure activities.
Who It Affects
Medicare fee-for-service beneficiaries (including those in rural and underserved areas), clinicians and practitioners who furnish telehealth, FQHCs/RHCs, Indian Health Service/tribal/Native Hawaiian facilities, CMS and its contractors, the HHS Office of Inspector General, and telehealth technology vendors. It also touches telehealth resource centers and organizations that measure quality.
Why It Matters
The bill converts many temporary pandemic flexibilities into statutory rules, creating longer-term operational expectations for payment, coding, oversight, and data reporting. For compliance officers and payers, the outlier-detection, public reporting, and clarified rules about providing technology to beneficiaries are the most consequential new obligations; for providers, payment deeming for FQHCs/RHCs and waiver pathways for new practitioner types change revenue and staffing calculus.
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What This Bill Actually Does
The bill rewrites large parts of Medicare’s telehealth framework in the Social Security Act. It eliminates the statutory geographic limitation on telehealth under section 1834(m) for services furnished on or after October 1, 2025, and it changes originating‑site rules so that a broader range of locations qualify beginning on enactment.
Those changes move previously temporary pandemic waivers into the statute and create new baseline rules for where beneficiaries may receive telehealth and which sites count for payment purposes.
On who can furnish telehealth, the Secretary receives express authority to waive limitations on practitioner types for services provided on or after October 1, 2025, if the Secretary finds a waiver clinically appropriate. That waiver authority must include safeguards the Secretary deems fit, an annual stakeholder comment process, and periodic reassessment not more often than every three years, with termination if a waiver is no longer clinically appropriate.The bill treats telehealth furnished by FQHCs and RHCs in two phases: an initial emergency-period treatment is extended and then, as of October 1, 2025, telehealth furnished by these entities as a distant site is deemed to be furnished as an outpatient of the clinic and payable under the FQHC prospective payment system or RHC payment methodologies.
Costs associated with furnishing the telehealth services are treated as allowable costs for these payment calculations. Separately, facilities of the Indian Health Service, tribes, tribal organizations, and Native Hawaiian health systems receive a specific exemption to originating-site requirements effective January 1, 2026.The bill removes the six‑month prior in‑person visit requirement for telemental health and clarifies that certain telehealth flexibilities tied to public health emergencies can be invoked when the Secretary declares a public health emergency under section 319 of the Public Health Service Act.
It also authorizes telehealth for hospice recertification during and after the emergency period and directs the Government Accountability Office to report within three years on impacts to hospice recertification and oversight.Title II adds program‑integrity tools: it amends the false claims/penalty statute to permit providers to furnish technologies directly to beneficiaries for telehealth or remote monitoring if the devices aren’t being used as part of solicitations and meet forthcoming regulatory conditions. It funds the HHS OIG with $3 million per year for FY2026–2030 for telehealth oversight.
CMS must identify clinicians with significant outlier billing patterns for telehealth using unique health identifiers, set thresholds for comparison within specialty and geography, notify identified clinicians with benchmarking and guidance, publish aggregate outlier data, and channel education through Telehealth Resource Centers. Finally, Title III requires CMS to develop beneficiary and provider training resources, study engagement tactics (with a report to Congress), review and integrate telehealth in quality measurement, and post quarterly CMS telehealth utilization and outcome data online within 180 days of enactment.
The Five Things You Need to Know
The bill removes Medicare’s statutory geographic restrictions for telehealth for services furnished on or after October 1, 2025.
The Secretary can waive limitations on which practitioner types may furnish telehealth and must create a public-comment process and at-most‑every‑3‑year reassessment for such waivers.
Starting October 1, 2025, telehealth provided by an FQHC or RHC as a distant site is treated as an outpatient FQHC/RHC service for payment and its related costs are allowable for prospective payment calculations.
The HHS Office of Inspector General is authorized $3 million per year for fiscal years 2026–2030, and the GAO must report within three years on the use of telehealth in hospice recertification.
CMS must identify significant outlier telehealth billing using standard unique health identifiers, notify clinicians with benchmarked comparisons, publish aggregate outlier data, and leverage Telehealth Resource Centers to educate identified providers.
Section-by-Section Breakdown
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Removal of Medicare geographic requirement
This amendment to section 1834(m) strips the statutory requirement that telehealth services be furnished only to beneficiaries in certain geographic areas. Mechanically, the change deletes the clause that tied payment to rural or shortage-area designations and makes the removal effective for services furnished on or after October 1, 2025. Practically, this brings statutory authority in line with pandemic-era practice and requires CMS to build new coding, claims‑processing, and monitoring workflows reflecting broader telehealth eligibility.
Expanding originating sites on enactment
This provision rewrites the originating-site language so that a wider set of places may qualify beginning on the date of enactment. Rather than rely on a temporary schedule, the bill sets an immediate statutory baseline for originating sites, which will change claims adjudication and may eliminate certain facility fees and place‑of‑service constraints. CMS will need to update its electronic specifications and provider guidance rapidly after enactment.
Secretary's waiver authority to broaden eligible practitioners
The bill inserts a formal waiver mechanism authorizing the Secretary to waive statutory limits on which practitioner types can furnish telehealth when clinically appropriate. The Secretary can attach beneficiary safeguards and program‑integrity requirements, must solicit stakeholder comment at least annually, and must reassess waivers periodically (no more often than every three years) with authority to terminate inappropriate waivers. Compliance teams should expect regulatory rules and monitoring tied to any waiver decisions.
FQHC/RHC payment treatment and Native facility exceptions
The legislation makes telehealth furnished by FQHCs and RHCs as distant sites payable under the FQHC prospective payment system or RHC payment methods beginning October 1, 2025, and directs that associated costs be allowable for those payment calculations. It also exempts Indian Health Service, tribal, tribal organization, and Native Hawaiian health facilities from originating‑site requirements effective January 1, 2026, and prevents an originating-site facility fee for facilities that meet only that exemption. These are material changes to revenue recognition and cost reporting for safety‑net providers.
Telemental health, PHE waivers, and hospice recertification
The bill repeals the six‑month prior in‑person requirement for telemental‑health services and clarifies that certain telehealth waivers may apply when the Secretary declares a public health emergency under section 319 of the Public Health Service Act. It also permits telehealth for hospice recertification during and after the emergency period and requires a GAO evaluation within three years to assess effects on recertification rates and oversight. Clinicians and hospices should expect procedural and documentation guidance from CMS tied to these changes.
Program integrity: technologies, oversight funding, and outlier detection
Section 201 amends the penalty statute to clarify that providers may furnish technologies (a term to be defined by regulation) directly to beneficiaries for telehealth and remote monitoring if not offered as advertising or solicitation and if other regulatory conditions are met. Section 202 authorizes $3 million per year for FY2026–2030 for OIG telehealth oversight. Section 203 requires CMS to use unique health identifiers to identify clinicians with significant outlier telehealth billing patterns, set thresholds for comparison within specialty and region, notify outliers with benchmarking, publish aggregate data, and expand Telehealth Resource Centers to deliver targeted education and technical assistance.
Beneficiary/provider supports, quality, and data transparency
The Secretary must issue beneficiary-facing resources and training on accessibility (limited English proficiency, disability, etc.), study strategies to improve beneficiary engagement with a report to Congress, develop provider training on payment and privacy, and review quality measures to ensure telehealth is incorporated. CMS must post quarterly telehealth utilization and outcome data within 180 days of enactment and produce technical guidance for stratifying measures by modality and population.
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Explore Healthcare in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Medicare beneficiaries in rural and underserved areas — broader place-of-service rules and elimination of geographic restrictions will increase the pool of accessible telehealth appointments.
- Patients needing behavioral health care — the repeal of the six‑month in‑person requirement for telemental health removes a documented access barrier to mental‑health services.
- Federally Qualified Health Centers and Rural Health Clinics — telehealth furnished as a distant site will be treated as outpatient clinic services and payable under FQHC/RHC payment methodologies, recognizing telehealth costs in PPS calculations.
- Tribal, Indian Health Service, and Native Hawaiian health facilities — the bill exempts these entities from originating‑site restrictions and shields certain facilities from originating-site facility fees, easing telehealth delivery in tribal settings.
- Clinicians and new practitioner types — the Secretary’s waiver authority creates a path for additional clinician categories to furnish Medicare telehealth when clinically appropriate, potentially expanding practice scope.
Who Bears the Cost
- CMS and HHS operational units — implementing statutory changes, updating claims systems, issuing guidance, running outlier-detection analytics, and producing required public data will require administrative resources and technical work.
- Providers and health systems — investment in telehealth platforms, documentation workflows, staff training, interpreter and accessibility supports, and compliance systems to manage new billing and monitoring expectations.
- Medicare Trust Fund (fiscal exposure) — broader access and removal of geographic limits could increase utilization and spending; actuaries and payers will need to monitor cost trends.
- Telehealth technology vendors and software developers — the unclear regulatory definition of allowable 'technologies' and new anti‑abuse guardrails will drive product-review and compliance costs.
- Clinicians flagged as outlier billers — receiving formal notifications and potential downstream audit scrutiny will require time and possibly legal or billing remediation costs.
Key Issues
The Core Tension
The central dilemma is balancing durable expansion of telehealth access with protecting Medicare integrity and fiscal sustainability: statutes that make telehealth widely available reduce access barriers but increase risks of misuse, higher utilization, and administrative complexity; the bill delegates many technical choices to the Secretary, forcing regulators to navigate trade-offs between access, oversight burden, and payment controls.
The bill tilts the statutory baseline toward much broader telehealth access, but many implementation details are left to the Secretary and CMS rulemaking. Key unresolved points include how CMS will operationalize national adjudication without reintroducing patchwork geographic policy via local coverage determination, how it will define and audit the class of technologies a provider may furnish to beneficiaries without triggering fraud-and-abuse exposure, and how payment deeming for FQHCs/RHCs will be calculated consistently across costs and across fiscal periods.
Program‑integrity provisions tighten oversight but create tension: outlier detection and public aggregate reporting are helpful for transparency, yet setting thresholds and benchmarking within specialty/geography will require complex analytics and careful guardrails to avoid false positives. There is also a risk that stronger oversight may chill legitimate telehealth expansion if providers fear audits or unclear device‑provision rules.
Finally, the bill mandates extensive beneficiary accessibility work and quality‑measurement integration without allocating a discrete, sizeable implementation fund; much of this will depend on HHS prioritization and reallocation of existing resources.
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