Pressure is mounting on Congress and the Biden administration to make permanent pandemic-inspired rules that fueled telehealth growth. Some fear fraud and ballooning costs.

As the COVID crisis wanes and life approaches normal across the U.S., health industry leaders and many patient advocates are pushing Congress and the Biden administration to preserve the pandemic-fueled expansion of telehealth that has transformed how millions of Americans see the doctor.

The broad effort reaches across the nation’s diverse health care system, bringing together consumer groups with health insurers, state Medicaid officials, physician organizations and telehealth vendors.

And it represents an emerging consensus that many services that once required an office visit can be provided easily and safely—and often more effectively—through a video chat, a phone call, or even an email.

“We’ve seen that telehealth is an extraordinary tool,” said David Holmberg, chief executive of Pittsburgh-based Highmark, a multistate insurer that also operates a major medical system. “It’s convenient for the patient, and it’s convenient for the doctor. … Now we need to make it sustainable and enduring.”

Last fall, a coalition of leading patient groups—including the American Heart Association, the Arthritis Foundation, Susan G. Komen, and the advocacy arm of the American Cancer Society—hailed the expansion of telehealth, noting the technology “can and should be used to increase patient access to care.”

But the widespread embrace of telemedicine—arguably the most significant health care shift wrought by the pandemic—is not without skeptics. Even supporters acknowledge the need for safeguards to prevent fraud, preserve quality and ensure that the digital health revolution doesn’t leave behind low-income patients and communities of color with less access to technology—or leave some with only virtual options in place of real physicians.

Some worry that telehealth, like previous medical innovations, may become another billing tool that simply drives up costs, a fear exacerbated by the hundreds of millions of dollars flowing into the burgeoning digital health industry.

Companies offering remote urgent care, virtual primary care, and new wearable technologies to monitor patient health are exploding, with the annual global telehealth market expected to top $300 billion by 2026, up nearly fivefold from 2019, according to research company PitchBook.

“I don’t think there’s any debate that there is a value in better access, but if this is just a one-off service that adds another billing option without fitting into patients’ regular care, I don’t know if it will do much for patients’ health,” said Tom Banning, head of the Texas Academy of Family Physicians.