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US Telemedicine at a Crossroads with Bills Awaiting Approval

2/19/2026

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​The telemedicine industry is well established in the United States, with the scope of available services constantly revised to reflect the latest metrics, regulatory concerns, and patient use profiles. In June 2025, legislators introduced the bipartisan bill HR 4206, the CONNECT for Health Act of 2025, into the US House of Representatives.

Supported by the American Medical Association (AMA), the bill employs the acronym CONNECT, which stands for Creating Opportunities Now for Necessary and Effective Care Technologies. It seeks to enshrine several temporary pandemic measures from 2021, including measures that ensured Medicare recipients had access to telemedicine and telemental services at home, without the need for in-person visits.

The bill seeks to eliminate geographical restrictions on the provision of telehealth services and to allow Medicare patients to conduct telehealth visits wherever stable audio or video connections are available. The bill also aims to repeal the Consolidated Appropriations Act of 2021 requirement that Medicare patients schedule an in-person physician visit within six months of their first telemental health session.

While Congress has consistently extended such flexibilities over the past five years, no steps have been taken to make them permanent. As of early September 2025, the companion bill to the Senate S. 1261 had 63 bipartisan cosponsors, a sign of progress toward enshrinement in law.

If the bill does not pass, the system will revert to what existed pre-COVID-19, with Medicare patients having minimal telemedicine access and no access in the convenience of their own homes. Before the pandemic, those who wanted to use telehealth services needed to live in approved rural areas and travel to an approved originating site for their consultations. This negated a large portion of telemedicine’s benefits, such as providing timely, informative care in the most convenient location.

Should waivers disappear and regulatory payment flexibilities be eliminated, patients would have less convenient, less accessible health care. This is no small matter for providers. Some 74 percent of physicians work in practices with telehealth, a threefold increase from before the pandemic.

Sanford Health, based in South Dakota, represents the nation’s most extensive rural health system and meets the needs of two million patients annually across 250,000 square miles. Two-thirds of those who rely on telemedicine are 30 miles or more from a major medical center. On average, patient travel is reduced by 176 miles each year through virtual care. In addition, 20 percent of behavioral health patients complete appointments via virtual visits, which have reached nearly a million over the past decade.

This integration of telehealth into the fabric of American health care extends to many providers, with AB 688, California’s Telehealth for All Act of 2025, requiring analyses and reports on telehealth utilization and access in the Medi-Cal program every two years, providing metrics that enable broader, more efficient use of telehealth. In addition, several bills have passed a single California chamber, including one that offers real-time telemedicine perinatal and neonatal consultations to maternity patients who live more than an hour from the nearest rural hospital.

Another bill in process seeks to create a CalHHS Data Exchange Board to improve oversight of data shared among government agencies and healthcare entities. This is particularly critical in an age of telemedicine, when specialists at various hospitals and clinics may be involved in resolving complex single-patient cases.

Peter Killcommons

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    Founder and Chief Executive Officer of Medweb, Dr. Peter Killcommons manages the operations of his company’s numerous divisions in medical imaging and philanthropy. ​

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