Americans love a good nailbiter, and that’s what we have with H.R. 7148, otherwise known as the Consolidated Appropriations Act, 2026. At the time of this writing, the bill has been passed by the U.S. House of Representatives, passed by the U.S. Senate, but the Senate made some changes; so, now, it’s back to the House for reconsideration and a possible vote.
Making Sausage
Most of us are aware of the famous quote attributed to Prussian statesman Otto von Bismark: “Laws are like sausages. It is best not to see them being made.” The haggling, the backroom dealing and back-and-forth squabbling can definitely make the process somewhat onerous and distasteful; but, every now and then, the U.S. Congress is capable of getting things done. Will it get something done relative to the Consolidated Appropriations Act? The following excerpt is from GovTrack, on Feb 2—the time of this writing—as to the status of H.R. 7148:
Passed Senate with Changes (back to House) on Jan. 30, 2026
This bill has been passed in the House and the Senate, but the Senate made changes and sent it back to the House on January 30, 2026. Other activity may have occurred on another bill with identical or similar provisions. The House Majority Leader indicated on Jan. 31, 2026 that this bill may be considered in the week ahead.
That “week ahead” reference points to this week. So, it may be that by the time you read this, H.R. 7148 will have already been passed and signed into law. Interestingly, the site goes on to list the prognosis of the bill’s passage as follows: “55% chance of being enacted.”
Okay, okay, so there’s a bill out there that’s on the brink of being passed; so what’s the big deal with this bill? Nothing much—just the future of telehealth.
What’s at Stake
According to one media outlet (Fierce Healthcare), “Medicare telehealth flexibilities and the Acute Hospital Care at Home (AHCaH) program are teed up to receive multiyear extensions from Congress in its recently released funding package for the Department of Health and Human Services (HHS).” Those flexibilities include extending—by two years (until Dec. 31, 2027)—the ability for telehealth services to be billed by Medicare providers even where:
- The patient is at his or her own home during the telehealth encounter
- The patient uses audio-only technology during the encounter (having met certain criteria)
This essentially allows providers and patients to continue virtual visits as they have since the beginning of the COVID-19 pandemic.
In addition, the acute hospital-at-home program would continue through Sept. 30, 2030. About 419 hospitals participate in the program and provide acute, hospital-level care to Medicare patients in their homes. It has been noted that “the program was significantly disrupted during the 43-day government shutdown that began Oct. 1.”
Finally, “If passed, the bill would also allow federally qualified health centers (FQHCs) and rural health clinics (RHCs) to continue furnishing telehealth services, including mental health visits,” according to commenters at Fierce Healthcare. “The bill would continue to delay the in-person visit requirement for all mental health visits until on or after Jan. 1, 2028.”
It’s clear that these extensions, if ultimately passed and signed into law, would provide more continuity and thus more stability for the healthcare industry than it has enjoyed in some time—at least in terms of the virtual visit environment. Since the end of 2024, providers and hospitals have faced a series of telehealth flexibility extensions and suspensions as Congress grappled with government funding crises. Having at least two years of care flexibility that providers and facilities can count on is seen by many as a real positive.