In terms of my writing schedule, this column is usually my annual plea for readers to consider donating to the Portland Press Herald Toy Fund. And I really hope you'll consider a donation if you have the means and a little extra holiday cash lying around. The fund is in a bit of a crunch this year, with 1,000 more requests for help than last year.

In terms of an economic bellwether, you can't beat the Press Herald's Toy Fund. When families tighten their belts, nonessentials are the first to go, and if the choice is between presents under the tree Christmas morning and rent, well, keeping a roof over your kid's head is the most important thing, even if it means holiday disappointment. Well, not on the Toy Fund's watch. Not if we can help it.

Related Toy Fund scrambles to serve every child after surge of applications

But I also wanted to bring to my readers' attention something important and time-sensitive: Telehealth as we currently know it will end on Dec. 31 unless Congress passes the Telehealth Modernization Act of 2024 in its annual end-of-year lame duck session.

It's been over four years now since Congress relaxed Medicare's telehealth ("telemedicine") rules, so you may not remember the restrictions on telehealth before 2020 (I sure don't). But prior to the expansion of telehealth, Medicare only covered it in narrow circumstances. Patients had to live in a rural area and, inconveniently, travel to a clinic or other designated location just to do a telehealth appointment. Now, you can have a telehealth appointment in your own home.

The telehealth rules were extended a few times, but they are currently set to expire on Dec. 31. If those rules expire, here is what anyone using Medicare is set to lose:

* The ability to use your home as the "originating site" of the telehealth visit, meaning people will once again have to travel just to do a Zoom with a doctor.

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* The ability to have Medicare compensate your provider for a host of different services, instead of the narrow pre-pandemic list.

* Coverage of audio-only visits, for patients who only have a phone and not a computer.

* Use of telehealth for hospice recertification, gone.

* Ability to see a mental health provider without a required in-person visit, gone. And more.

While these rulings technically apply to Medicare, private insurers usually follow Medicare guidelines when it comes to coverage, and they'll take any excuse to cut their costs and deny coverage for visits.

I have personally greatly benefited from using telehealth services. Primarily I have used it for my kidney donation-related follow-ups and follow-ups with a pain medicine doctor. I live an hour from where those doctors are located in Portland. It doesn't make any sense to drive two hours just for the doctor to tell me my labs look good and to avoid excessive sodium intake.

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Having access to telehealth has saved me money, in terms of gas, as well as time. It's made me a better worker because I've had to take less paid time off for the visits. It helps me stay healthy by avoiding exposure to other, possibly sick, people.

Telehealth isn't perfect. It isn't a solution for the main health care problem rural Maine faces, which is that we simply do not have enough providers. We don't have enough specialists or primary care providers and the ones who are there are overworked and underpaid. But restricting its use to pre-pandemic standards won't help anyone except maybe people who want to cut Medicare funding.

I mean, come on. Mandating in-person visits for hospice recertification? Hospice? My dad went through hospice care and I can't imagine trying to transport him in that state to a doctor's office. No good will come from cutting telehealth eligibility. None.

Fortunately, there's a solution on the table. The Telehealth Modernization Act of 2024 has been introduced into Congress. It's a bipartisan bill that would permanently extend the current Medicare telemedicine flexibilities, including by allowing rural health clinics and Federally Qualified Health Centers to serve as the location of the provider (they weren't included previously, can you imagine?), allowing the patient's home to be the "originating site" of the visit and allowing all sorts of practitioners to practice telehealth.

This bill's sponsor is Rep. Earl Carter, a Republican from Georgia. You know it's serious if a Southern Republican is trying to expand a government service rather than cut it. When I heard that the bill was in danger of not being passed, I immediately called the D.C. office of my congressional representative, Chellie Pingree, as well as the offices of both Maine's senators.

For the record, both Pingree and Susan Collins' office lines went straight to a voicemail, and at Sen. King's office, a woman picked up on the second ring and took my message. (Good customer service, kind intern.) I would recommend you do the same, and tell your friends, too (especially if they live in the 2nd Congressional District).

Personally, losing access to telehealth would be inconvenient for me, but I would manage. For other people who aren't as lucky -- those who live four or five hours away from Portland, instead of just one -- it could very well be devastating. Not exactly a happy new year.

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