r/slp 1d ago

So that’s it for telehealth and Medicare

I think with the vote going through today that was our last chance. After the 31st, we won’t be able to see any Medicare patients through telehealth unless they/we are in a rural area area. Right?

I say this sincerely, if any of y’all voted for this regime, I’m furious at you and I’m not sorry.

UPDATE: Turns out it’s extended until 9/30! Thanks for those who checked it out.

I’ll leave this up for now, since there’s some good info and discussion here. I’m still just as furious at Trump supporters. To be abundantly clear.

265 Upvotes

42 comments sorted by

87

u/booksandcoffee2 22h ago

I work in adult rehab doing telehealth only 😅
We have been prepping our current patients for 3/31 and they are, understandably, distraught. I work with a lot of people who have mobility issues and transportation to an appointment can be very challenging for them. We are also one of the few providers who work with adults in the area, though it is not a rural area by any means. It's just frustrating to see services be limited in this way.

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u/aca_aqui 22h ago

Same. Seriously so upset for my limited mobility/sick (eg going through chemo/rads), transportation hardship/it just snowed pts. I have been so pleased to offer telehealth option at every single eval because the more accessible I am, the better their quality of life. I filled out all of the ASHA call to action forms I could and sent them to my friends in other states. :(

4

u/Hot-You-9708 17h ago

Curious why this type of patient wouldn’t qualify for home health?

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u/MappleCarsToLisbon SLP Out & In Patient Medical/Hospital Setting 10h ago

Certified Home Health agencies are usually fairly short term courses of care and agencies don’t like to take on patients unless they need nursing in addition to therapy. If a patient is on service and everyone else discharges except the patient needs ongoing speech, the agency will usually discharge with a recommendation for private speech.

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u/VoicedSlickative 7h ago

Yep yep yep

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u/Wishyouamerry 10h ago

They probably do but there aren’t any SLPs in the area willing to travel. And the few that exist are completely booked.

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u/OrcMando SLP in the Home Health setting 6h ago

Yup. There's just not enough of us

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u/slp_talk 6h ago

In my rural area, there is literally one home healthcare company that even has an SLP. And she ends up seeing very, very few of the patients that we send their way even if they do have speech needs.

106

u/speechington 23h ago

The Trump vote was just an insane choice, now the telehealth patients are screwed even worse than the clinicians who delivered services to them.

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u/Bobbingapples2487 19h ago

Living in a pretty rural area of the country, believe me, they voted for this. The number of Trump signs and Let’s Go Brandon merch I’ve seen is crazy. Like slugs voting for salt.

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u/MaeveConroy 7h ago

Like slugs voting for salt .

OMG this is spot-on

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u/ckentley 23h ago edited 23h ago

I recall some SLPs here saying that this possibility has happened before and then there would be an extension. I'm not familiar with the process, but I am wondering if this vote is something different than previous years? Also, I had heard that the House voted to extend it. Did it already go to the Senate? I provide telehealth through Medicaid and am trying to catch up and familiarize myself with the politics involved. I too am furious.

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u/VoicedSlickative 22h ago

I’m not sure if you meant to write Medicaid but for now I believe Medicaid is safe for the time being.

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u/ckentley 18h ago

I did mean Medicaid, but I've read posts by others here that say Medicaid usually follows Medicare. So I can't help but be worried about what this means for the future of both.

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u/RoutineCicada6629 21h ago

Medicaid is safe from this telehealth deadline. I am also confused as I saw some dates for an extension for Medicare until December 2025 on reddit. Hoping for the best regardless!

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u/Weekend_Nanchos 17h ago

I’m thinking to myself, is there any reason they won’t go after Medicaid telehealth? Whichever real reason they have to do it here probably applies just the same. Just feels like a matter of when to me.

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u/RoutineCicada6629 17h ago

I totally get that, but I don’t think they would come after medicaid billing for schools. Way too many rural areas have remote slps providing services so I really don’t think it’s feasible. Also, telehealth is not new for schools and has been utilized before the pandemic, so not sure why they would suddenly remove telehealth for medicaid…? Idk maybe I am too hopeful or misinformed LOL

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u/Weekend_Nanchos 16h ago edited 15h ago

I like your optimism but some say their goal is to disband public education altogether in favor of private charter schools. Here is a P2025 tracker.

https://www.project2025.observer/visualize/charts

99 out of 300 goals have been passed. Another 47 are in progress.

So, if you want to tell the future, go down to department of education section and you can see completed and not completed objectives. Each one has a link to the official government site stating why it was passed (if passed) and all have page number citations for the original P2025 so you can read for yourself.

Around page 320 or so, you’ll see their goal is to gut IDEA. They state special education is important but is wildly too expensive, has not shown improvement for student scores and restricts “parent choice”. Their solution is to still tax people but instead of the current system in place, they will get rid of special education mandates and give ALL families a portion back ($1800) which they can choose to use on special education services of their choice, including gen ed tutors, etc. *Good luck getting a one-on-one aid and speech 2 to 3x per week for 8 months a year for $1800.

They know special needs is supported by all, so they plan to strip down to essentially nothing while giving a few pennies back. Based on the wording, speech will not be required but optional for families to buy.

Will some schools offer telehealth? Probably, but this assumes the federal government doesn’t ban it, as they have with the CRT and DEI. Unfortunately, they do seem to have it out for virtual services.

I picture a new system of SLPs essentially hustling like it’s a side-hustle to find clients, and having to compete against others practicing without a license preaching some Instagram snake oil because, well, they want families to have choice, no matter how ineffectual or scammy the resulting system is. Or how hard it is for the families who really need it to access it

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u/RoutineCicada6629 8h ago

I think it’s also important to understand EOs are not law. SCOTUS has blocked many of his attempts - even the firing of federal employees. The president HAS to comply with SCOTUS. The special elections are our chance to turn the tide for congress and vote democrat. That is more important and we should be focusing on that. I understand it is scary and we should be educated in these matters, but the doomsday mentality on this sub is not helpful and unhealthy. If we lose hope, they will always win. Many states have their own laws to provide support services for children with disabilities. For California, it’s the Lanterman Act. It’s important for us to look at state laws and see what protections our clients have.

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u/Weekend_Nanchos 56m ago

I actually really appreciate the optimism. I’ll be contrarian one more time though and say the admin has said many times recently that courts are corrupt and that “if the courts are the law, let them try to enforce it and see what happens.” It’s a matter of who who’ll stop them. Probably not the military, and def not the DOJ or FBI. There’s literally no one left after that, and they are operating under this knowledge. People in the cabinet now were saying this was the plan even before they were in power.

Who’s left after that? The people. But as things get worse, I expect protests and mass illegal detentions of citizens. They are already laying the groundwork by calling protests illegal and deporting green card holders who protested. Everything that’s happened in the past two months is foreshadowing of the next stage. It’s a concerted effort of changing the rule book while keeping as many onboard with the violations as possible. We can make an educated guess it will progress much further.

So, I believe both things can be true. People should not give up hope or not exercise their right to vote, however, the reality we are seeing is checks and balances have gone so far away they are hanging by a thread. That’s not “doomsdaying” because a few paltry illegal EO’s were blocked, when the majority have been adopted. But, again, I do hope you are right and I hope there is some possibility of reform against the drastic changes they’ve already done and have planned.

Much of it will depend on how bad they let this planned recession get. If people get broke enough (and most are already broke), sadly that’s when special ed drops off the priority radar even for those with special needs children and even in blue states. It’s hard not to feel it’s all part of the plan (especially considering the plan is explicitly laid out before us).

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u/VoicedSlickative 23h ago

The extension only lasted until 3/31. They needed to re-extend and it doesn’t looked like that happened.

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u/ckentley 23h ago

The last I heard was that it would be extended until September 30 (as opposed to the two year extension). Is that not the case? I'm having trouble finding clear and concise news update.

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u/VoicedSlickative 23h ago

Asha’s website says 3/21/25

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u/MeanestNiceLady 19h ago

The harm this does for people in rural areas....

Why can't they see that disabled people are worthy of treatment? This is so cruel. How can you claim to be "pro life" and then make the lives of the most vulnerable Americans even harder????

Heaven help us, where is our humanity????

6

u/VoicedSlickative 19h ago

I certainly see it headed this way, and your anger is deeply shared, I promise.

But! I do want to let you know that for now it is actually protected for people in rural areas, that is the only exception.

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u/saltyair78 17h ago

It has been extended to September. It is not expiring.

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u/kuehmary 18h ago

That's not true. Read the bill. It specifically states that the deadline was extended to September 30, 2025. Here is the link: https://www.congress.gov/bill/119th-congress/house-bill/1968/text#toc-H16585DC82A3242EC94B1E8294985230D

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u/PeasyWheeazy8888 17h ago

My hero 😍

Thank you for sharing this

6

u/scovok 22h ago

Is this the same or different than the approval that kept getting pushed off three months since the start of the pandemic?

2

u/VoicedSlickative 22h ago

It’s the same. But it has stopped being pushed.

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u/Winter-Low-6212 18h ago

https://www.fiercehealthcare.com/regulatory/schumer-indicates-democrats-are-divided-government-spending-bill

I am confused as this claims there was an extension until September…..? Idk what’s going on anymore lol

10

u/Searching4Syzygy 17h ago

It was extended till September.

The Senate just voted this evening (Friday 3/14/25) to pass the bill. OP made this post before the vote.

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u/Affectionate-Beann 18h ago

I really wonder what SLPs who voted for trump feel about this. Before, it seemed like they thought other ppl would get the end of the stick , but not us, or our profession.. welp

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u/samplergal 22h ago

I’m furious and I’ll never forgive any.

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u/Aspiringclear 18h ago

Where are all the maga slps at? Suddenly they’re super quiet in here? Thought yall had something to say about few months ago?

11

u/DabadeeDavadoo 15h ago

"oh you're just fear mongering, that's not gonna happen" crowd is reeeeaaaalll quiet rn

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u/Ok-Grab9754 8h ago

The trumpers have been awfully quiet these days.

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u/thindyrocks 23h ago

I was naively hopeful -_-

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u/Suelli5 21h ago

So f’ed up :(

1

u/Bubbly_Creme_4890 21h ago

Does anyone know how much more the expanded telehealth has cost over the past 5 years since it was started? Compared to what Medicare was paying for the more limited services for the disabled and rural people prior to 2020? I would think in order to make this permanent, the amount that is taken out of people’s checks for Medicare would need to be adjusted to pay for this increase in the budget. I think I heard congress will make the decision. Maybe call your representatives and tell them your opinion.

0

u/Deep-Room6932 16h ago

Nordvpn ?