Press Releases

WASHINGTON, D.C. — Congresswoman Teresa Leger Fernández (NM-03) introduced the Telehealth Access for Tribal Communities Act of 2025, crucial legislation designed to protect access to essential healthcare services through audio-only telehealth for Medicare beneficiaries in tribal communities.

The bill is co-sponsored in the House by  Congressman Jay Obernolte (CA-23), Congresswoman Melanie Stansbury (NM-01), Congressman Raul Ruiz (CA-25), Congresswoman Eleanor Holmes Norton (DC), and Congresswoman Norma Torres (CA-35).

The bill seeks to extend the COVID-19 Public Health Emergency (PHE) provision that allows audio-only telehealth services for Medicare beneficiaries receiving care through Indian health programs or urban Indian organizations beyond 2025. This provision addresses the persistent challenge of access to healthcare in Indian Country where many residents face long drives to see a medical professional and millions don’t have access to reliable high-speed internet. As the COVID-19 Public Health Emergency (PHE) expired in May 2023, IHS patients used audio only services 60% of the time and video 39% of the time.

“Not everyone has access to Zoom or the internet. Indeed, the folks most in need of healthcare services don’t. Access to healthcare should not be determined by zip code or internet speed,” said Congresswoman Leger Fernández. “For many tribal communities, audio-only telehealth services are a lifeline, providing vital access to medical professionals without the burden of travel. While audio-only telehealth should not be the only way to access healthcare services, it should be protected for those who may not have other options. The Telehealth Access for Tribal Communities Act will ensure that our elders, families, and those living in remote areas continue to receive the care they need.”

Background: 

Audio-only telehealth involves real-time interactive voice-only discussions between a patient and a provider, requiring only a working phone. 

According to the Government Accountability Office (GAO), in 2020, 18% of people living on tribal lands couldn't access broadband service, compared to 4% of people in non-tribal areas.

During the COVID-19 Public Health Emergency (PHE), Medicare began reimbursing the Indian Health Service (IHS) for specific audio-only telehealth services provided to Medicare beneficiaries. This included allowing patients to receive care from the comfort of their homes. Although the PHE ended on May 11, 2023, Congress extended this flexibility through December 31, 2024, under the Consolidated Appropriations Act. The December CR extended all Medicare telehealth flexibilities, including the Congresswoman’s bill, until March 31^st, 2025, and the March CR extended all Medicare telehealth flexibilities until September 30, 2025. Without further extension through this new legislation, Medicare may cease to reimburse IHS for these essential services, jeopardizing healthcare access for tribal communities.

The bill removes originating site requirements, allowing Medicare beneficiaries to remain in their homes for audio-only telehealth visits, rather than needing to travel to a healthcare facility.

The Telehealth Access for Tribal Communities Act has garnered strong support from a range of organizations, including:

• National Council for Mental Wellbeing
• National Council of Urban Indian Health
• National Indian Health Board
• The Great Plains Tribal Leaders Health Board 
• National Congress of American Indians
• Confederated Tribes of the Colville Reservation
• The Navajo Nation 
• Northwest Portland Area Indian Health Board
• American Telemedicine Association 

“The National Council of Urban Indian Health is grateful for Representative Leger Fernández’s dedication to improving health outcomes for American Indian and Alaska Native communities. Maintaining the Public Health Emergency’s Medicare reimbursement of audio-only telehealth will help our Native elders have continuity and access to critical health care,” said Francys Crevier (Algonquin), CEO, National Council of Urban Indian Health  

“This legislation allows Indian health programs and the individuals they serve the permanent flexibility to use telehealth services under Medicare. Telephonic telehealth has been a popular and critical access point for care for rural patients, including our Elders who live in some of the most remote parts of Indian Country. Without broad access to reliable broadband services, telephonic telehealth will continue to be an important access point for Medicare services. NIHB is proud to support this much needed legislation,” said William Smith, Chairman, National Indian Health Board.

"The National Congress of American Indians (NCAI) remains steadfast in its support for the Telehealth Access for Tribal Communities Act of 2025, recognizing its vital role in ensuring permanent telehealth services for Indian Country. Access to quality healthcare must align with the unique needs of Tribal Nations, and telehealth is an essential part of that framework. Telehealth is an important platform in the myriad broadband technological needs of Tribal Nations as well.  We urge Congress to continue building upon these critical healthcare infrastructure efforts so that all Tribal citizens, now and for generations to come, have the care they deserve," said Larry Wright Jr., Executive Director, National Congress of American Indians .

“Audio-only telehealth offers an essential alternative option for our tribal communities who face barriers to video consultations, such as lack of technology, privacy concerns, or limited internet access. The mission of the Northwest Portland Area Indian Health Board is to eliminate health disparities and improve the quality of life of American Indians and Alaska Natives. This legislation contributes to NPAIHB’s mission by bridging the gap for tribal communities who may lack high-speed internet or the latest technology by ensuring accessibility to quality healthcare for all. NPAIHB is pleased to endorse the Telehealth for Tribal Communities Act introduced by Representative Leger Fernández,” said  Aaron Hines, Chair, Northwest Portland Area Indian Health Board.

“Telehealth has been a lifeline to many in tribal communities, improving access to care for those facing issues like geographic isolation and lack of technology infrastructure. We support the Telehealth for Tribal Communities Act, which would ensure Medicare beneficiaries can continue to receive audio-only telehealth services, even when broadband is not available. We are grateful for the ongoing bipartisan support for telehealth services and thank Congresswoman Teresa Leger Fernández and her Congressional colleagues for advancing this important legislation,” said Kyle Zebley, Senior Vice President, Public Policy, American Telemedicine Association and Executive Director, ATA Action. 

To read the full bill, click here.

To read the one-pager, click here.