House Sends Legislation to President Trump Reopening Government; Extends Telehealth Flexibilities

(from Alliance Daily)

The evening of November 12, the U.S. House of Representatives passed the Senate Amendment to H.R. 5371, the Continuing Appropriations and Extensions Act, 2026, sending it to the President for signature and officially ending the 43-day government shutdown – the longest in U.S. history. 

This legislation includes a Continuing Resolution (CR) which funds most of the government through January 30, 2026, at current fiscal 2025 levels and provides full-year fiscal 2026 funding for the Agriculture Department, the Food and Drug Administration, the Legislative Branch, military construction projects, and the Veterans Affairs Department.  

In addition to funding the government, the legislation includes several provisions important to the care at home community. 

Telehealth 

The legislation extends COVID-19 era telehealth flexibilities through January 30, 2026, retroactively, as if the flexibility never lapsed. Previously, these flexibilities had expired on September 30, 2025. 

 For home health agencies, the originating site and geographic location restrictions under 1834(m) are again waived, meaning the face-to-face (F2F) encounter can again be performed broadly via telehealth in accordance with 1834(m) of the Social Security Act. 

For hospice providers, the required F2F encounter prior to the third or subsequent benefit period can again be performed by a hospice physician or nurse practitioner via telehealth. 

The Alliance recognizes the adverse impacts from the lapse in telehealth on patients and providers and will continue advocating for a permanent extension of these critical flexibilities.  

Hospice Surveys 

Section 6205 of the legislation provides for $2,000,000 in funding for Medicare Hospice Surveys. This is a continuation of funding, originally included in the IMPACT Act of 2014, that expired on September 30, 2025, to ensure all hospices receive a survey at least every 36 months. 

Statutory PAYGO 

The Statutory Pay-As-You-Go Act of 2010 (Statutory PAYGO) requires that mandatory spending and revenue legislation not increase the federal budget deficit over a 5- or 10-year period. Should legislation be enacted that increases the deficits without offsets, the Office of Management and Budget (OMB) is required to implement sequestration, in addition to the current 2% reduction.  

This legislation waives the Statutory PAYGO requirement through 2026, zeroing out PAYGO scorecard, which included $3.4 trillion in deficit spending resulting from the One Big Beautiful Bill (OBBA). Without this waiver, providers would have been subject to an additional sequestration cut of roughly 4% to Medicare payments. 

Veterans Affairs 

The full-year appropriations for the Veterans Administration will provide more certainty regarding the ongoing stability of VA health services. Though VA Health Care had advance appropriations and was not as directly impacted by the shutdown as other parts of the Federal government, there were some operational and logistical delays that arose, which should be alleviated through the full-year appropriations package. 

 Included in the CR through January 30, 2026, is the Department of Defense, which funds TriCare. During the shutdown, TriCare was unable to process and pay medical claims for services and this will allow reimbursement for services provided from October 1, 2025 through the end of the CR. Members who provide services under TriCare could be impacted if funding were to again lapse at the end of January.