Funding delays trigger telehealth chaos and patient access disruption

As Congress raced toward another funding deadline, physician practices were once again caught in the churn of expiring health care “extenders” and last-minute fixes.

In this Physicians Practice interview, Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association, explains how short-term funding patchwork can cancel Medicare telehealth visits, force abrupt workflow changes, and leave practices operating in limbo even as lawmakers weigh a longer extension through 2027.

Physicians Practice: Let’s get right into it. Anders, when Washington punts on funding at the last minute, what’s the first thing that breaks down for medical groups: staffing, cash flow, or patient access?

Anders Gilberg: I think you’re referring to the aftermath of the government shutdown in the fall, and we’re up against another deadline soon.

Physicians Practice: Jan. 30, right?

AG: That’s right. And what happened then, I don’t think we’ll have the same issues this time. I don’t think the government is going to shut down. But it was a real problem.

Medical groups and physician practices have been dealing with this for a while, especially since the end of 2024, when a lot of things important to them, like the ability to provide telehealth or move into an alternative payment model, got delayed. These are what we call health care extenders.

In the fall, we had a situation where telehealth flexibilities in Medicare basically expired, the policies that allow physician practices to provide telehealth in Medicare at all. And while the government was shut down, they were reinstated, but it caused real problems for practices trying to maintain continuity of care.

A lot of telehealth appointments were canceled. Practices had to bring patients in physically, which created issues around transportation, reimbursement, and everything that comes with changing workflows on the fly.

That’s the disruptive part: practices have to change midstream, only to then have Congress reinstate policies a few weeks later. Telehealth is one example. There were others. But when Congress can’t agree, or delays implementation, practices feel it immediately.

Physicians Practice: You mentioned telehealth extensions. They’ve extended it a couple times. If they keep extending it but don’t make it permanent, is that really progress, or are practices stuck in limbo?

AG: There’s been some concern with telehealth. It took off during COVID, and I think everyone acknowledges it’s beneficial for beneficiaries. That’s not really the debate anymore.

The apprehension has been: Would it increase fraud? Could it introduce more fraud into the system? Could it drive up volume, Medicare patients getting excessive amounts of care? Would it cost the system more?

But a lot of those concerns haven’t borne out. And because of that, there’s more appetite now to extend it.

At the end of this month, there’s an appropriations bill being considered by the House and Senate over the next week or so. What’s notable is it doesn’t just do a short-term patch. It would extend telehealth through 2027, which is a lot better than what we’ve been seeing, where Congress kicks the can for three or four months at a time and then you’re right back in the same uncertainty.

So that’s a positive sign that Congress is starting to think longer-term. But we have to make sure the bill passes, and it needs to be enacted by the end of the month to keep the government running.