The CONNECT for Health Act of 2025 amends Medicare (title XVIII) to make several temporary COVID-era telehealth flexibilities permanent and to add new authorities and oversight tools. Key changes include removing geographic restrictions on telehealth starting October 1, 2025; expanding what locations and practitioner types may participate; treating FQHC and RHC telehealth as billable outpatient services; exempting many Indian Health Service and tribal facilities from originating-site rules; and eliminating the six-month in‑person requirement for telemental-health.
Beyond coverage, the bill layers in program-integrity and support measures: a clarified fraud-and-abuse carve-out for devices provided to beneficiaries, $3 million per year (FY2026–2030) for HHS Inspector General telehealth oversight, an outlier-billing detection-and-education program using standard identifiers, GAO and CMS reporting requirements, and new beneficiary- and provider-facing training and accessibility guidance. These changes broaden access but also create new administrative work for CMS, contractors, and providers and raise questions about monitoring, payment impacts, and quality measurement.
At a Glance
What It Does
The bill removes Medicare’s geographic originating-site requirement for telehealth as of October 1, 2025, expands allowable originating sites and practitioner categories, and ensures FQHCs and RHCs are paid and treated as outpatient providers for telehealth. It also creates program-integrity tools (fraud carve-outs, OIG funding, outlier detection) and mandates beneficiary/provider guidance, quality-measure reviews, and public data posting.
Who It Affects
Medicare fee-for-service beneficiaries, clinicians who furnish telehealth (including expanded practitioner types after Secretary waivers), FQHCs, RHCs, Indian Health Service/tribal/NHHC facilities, telehealth vendors, CMS and Medicare administrative contractors, and oversight bodies (OIG, GAO).
Why It Matters
The bill institutionalizes many pandemic telehealth flexibilities and pairs expansion with oversight and reporting—shifting telehealth from an emergency patch to a durable component of Medicare delivery while creating operational, billing, and measurement workstreams CMS and providers must absorb.
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What This Bill Actually Does
This bill converts a number of COVID-era telehealth rules into standing Medicare policy while adding targeted guardrails. It removes the longstanding geographic requirement effective October 1, 2025, meaning Medicare will no longer limit telehealth to beneficiaries in rural Health Professional Shortage Areas or specific originating sites.
Simultaneously, the statutory text expands the permitted originating-site framework (effective on enactment) and specifically treats telehealth furnished by Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) as outpatient services eligible for applicable prospective payments and allowable cost treatment.
The Secretary gains flexible authority to waive limits on which practitioner types may furnish telehealth starting October 1, 2025, provided the Secretary finds such waivers clinically appropriate; the statute requires a process for public comment and periodic reassessment (no more frequently than every three years). For Native American, tribal, and Native Hawaiian facilities the bill creates a targeted exemption: originating-site rules will not apply for telehealth furnished by those facilities beginning January 1, 2026, and it removes the originating‑site facility fee for facilities that only qualify under that exemption.On program integrity, the bill narrows anti-kickback/statute language to allow the direct provision of technologies to beneficiaries for telehealth and remote monitoring if the devices aren’t used as marketing and meet Secretary-defined rules.
It authorizes $3 million per year (FY2026–2030) for the HHS Inspector General for telehealth oversight and directs the Secretary to identify significant outlier billing patterns using unique health identifiers, notify providers, publish aggregate patterns, and coordinate educational outreach through Telehealth Resource Centers. It also repeals the six‑month in‑person requirement for telemental‑health and extends telehealth use for hospice recertification beyond emergency periods, with a GAO evaluation due within three years.Finally, the bill requires beneficiary-facing resources (accessibility, interpreter use, accommodations for disabilities), provider education (payment rules, privacy, serving vulnerable populations), a review of quality measures to ensure telehealth is captured and stratified by modality, and quarterly public reporting on telehealth utilization, expenditures, and related outcomes on CMS’s website.
Those operational duties create immediate deliverables for CMS, contractors, and outreach partners to implement within months of enactment.
The Five Things You Need to Know
The bill eliminates Medicare’s geographic originating-site restriction for telehealth effective October 1, 2025.
The Secretary may waive practitioner-type limitations for telehealth beginning October 1, 2025, subject to annual public comment and reassessment at least every three years.
Telehealth services furnished by FQHCs and RHCs on or after October 1, 2025, will be treated as outpatient services for payment under the FQHC prospective payment system or RHC payment rules, and related costs will count toward allowable costs.
The bill authorizes $3,000,000 per year (FY2026–2030) to the HHS Inspector General for telehealth audits and oversight and requires CMS to identify and notify significant outlier telehealth billers using standard unique health identifiers.
Native American, tribal, and Native Hawaiian health facilities are exempted from originating-site requirements for telehealth starting January 1, 2026, and the bill removes certain originating-site facility fees for those facilities.
Section-by-Section Breakdown
Every bill we cover gets an analysis of its key sections.
Remove geographic restrictions for telehealth
Amends section 1834(m) to strike the statute’s geographic limitations so that telehealth services furnished on or after October 1, 2025 are no longer bound by originating-site geographic tests. Practically, this allows beneficiaries in urban and non-designated areas to receive Medicare-covered telehealth without the previous rural/location constraints.
Expand authorized originating sites and conforming edits
Rewrites the statutory language on originating sites to take effect upon enactment and makes conforming edits to payment and reporting paragraphs. The change accelerates which locations qualify as originating or distant sites and removes sunset phrasing tied to September 30, 2025, consolidating policy under the new permanent framework.
Secretary authority to waive practitioner-type limits
Creates a new, contingent waiver authority allowing the Secretary to relax statutory limits on which practitioner types may furnish telehealth beginning October 1, 2025 when clinically appropriate. The clause requires the Secretary to establish beneficiary and program-integrity conditions for waivers, solicit stakeholder input at least annually, and reassess waivers on a periodic schedule (no more frequently than every three years).
FQHC/RHC payment treatment and tribal facility exemptions
Section 104 spells out that telehealth furnished by FQHCs and RHCs on or after October 1, 2025 should be treated as outpatient services for FQHC prospective payment or RHC payment calculations and that associated telehealth costs are allowable for PPS/AIR calculations. Section 105 exempts Indian Health Service, tribal, and Native Hawaiian health facilities from originating-site rules beginning January 1, 2026 and prevents certain originating-site facility fees from applying to facilities that qualify only under this exemption.
Remove six‑month in‑person requirement for telemental health
Amends the telemental-health statutory provisions to eliminate the requirement that beneficiaries have an in-person visit within six months before tele-mental-health services, and removes similar temporal limits for RHCs and FQHCs—thus allowing continuity of remote mental-health care without that prior in-person trigger.
Public health emergency waivers and hospice recertification by telehealth
Section 107 expands the statutory definition of ‘emergency period’ to encompass public health emergencies declared under section 319 of the Public Health Service Act, clarifying waiver authority. Section 108 allows telehealth use in hospice recertification during and after the described emergency period and directs GAO to report within three years on recertification patterns and oversight implications.
Program integrity: device carve-out, OIG funding, and outlier detection
Section 201 adds a carve-out to the anti-kickback/false claims framework to permit providers to give technologies to beneficiaries for telehealth/remote monitoring if not used for solicitation and if they meet Secretary-defined regulatory conditions. Section 202 authorizes $3M annually (FY2026–2030) for the HHS OIG for telehealth oversight. Section 203 instructs the Secretary to use standard unique health identifiers to identify significant outlier telehealth billers, set thresholds, notify providers with comparative data, publish aggregate patterns, and fund Telehealth Resource Centers to provide education and referrals.
Beneficiary/provider supports, quality measurement, and transparency
Requires CMS to produce beneficiary-facing resources and training (LEP, disability accessibility, captioning), provider education on telehealth payment/privacy and serving vulnerable populations, a review to ensure telehealth is included in quality measures with technical guidance for stratifying measures by modality, and quarterly public posting of telehealth utilization, spending, and outcomes on the CMS website.
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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 (including urban and homebound patients): Removing geographic limits and the six‑month in‑person rule expands who can get telehealth, increasing access for those with mobility, transportation, or distance barriers.
- FQHCs and RHCs and their patients: Treating telehealth as outpatient services under FQHC/RHC payment methodologies preserves revenue streams and recognizes telehealth-related costs as allowable, supporting safety-net providers’ financial viability.
- Native American, tribal, and Native Hawaiian health systems: The originating-site exemption and facility‑fee adjustments reduce administrative friction and broaden telehealth access for tribal populations served by IHS and tribal facilities.
- Behavioral health patients and mental-health clinicians: Repeal of the six‑month in‑person requirement for telemental‑health removes a barrier to continuity of care for remote behavioral health services.
Who Bears the Cost
- CMS and federal oversight bodies: Expanded benefits, new reporting, public dashboards, GAO evaluation, and OIG-funded oversight create administrative and budgetary workstreams for CMS and contractors.
- Clinicians and practices (particularly small practices): New documentation, compliance expectations, and potential outlier monitoring/education increase operational burdens and may trigger audits or corrective actions.
- Medicare trust funds/federal budget: Removing geographic limits and broadening paid sites/practitioners could increase utilization and program spending; CMS must manage cost exposure within budget constraints.
- Medicare administrative contractors and Telehealth Resource Centers: Responsible for notifications, education, and referrals under the outlier program, adding workload and coordination responsibilities.
Key Issues
The Core Tension
The bill pits two legitimate goals against each other: making telehealth a durable, widely available mode of care to improve access versus guarding Medicare’s integrity, quality, and fiscal sustainability. It expands access through statutory permanence while relying primarily on administrative oversight, education, and post-hoc detection to control misuse—leaving CMS to balance access gains against program‑integrity and budgetary risks.
The bill’s central policy move—permanent expansion of telehealth—improves access but concentrates policy risk in implementation. Removing geographic limits and broadening practitioner eligibility will likely increase telehealth utilization, but Congress pairs those expansions with largely descriptive and educational enforcement tools rather than new statutory payment controls.
That mix reduces immediate statutory constraints but places heavy reliance on CMS rulemaking, contractor analytics, and OIG activity to detect and deter inappropriate billing.
Operationally, CMS must define multiple regulatory elements the statute leaves open: what devices and technology are covered by the fraud carve-out and under what conditions; specific thresholds and comparators for outlier detection using standard unique identifiers; how FQHC/RHC telehealth costs are accounted for in PPS/AIR; and the content and enforcement weight of provider/beneficiary guidance. Those choices will determine whether expanded access comes with meaningful program-integrity protections or shifts the problem into administrative dispute resolution and contractor audits.
Broadband access and patient digital literacy are unaddressed funding gaps—the bill requires education and supports but does not fund large-scale connectivity solutions.
On quality, the bill mandates measure reviews and technical guidance but does not create binding telehealth-specific outcome incentives or explicit modality parity in measure reporting. That leaves room for telehealth to be captured in quality programs unevenly unless CMS prioritizes harmonization across settings.
Finally, the Secretary’s waiver power to expand eligible practitioners can improve access where workforce shortages exist but may trigger scope-of-practice and state licensure conflicts and will require careful clinical guardrails and periodic reassessment to avoid diluting clinical appropriateness standards.
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