Inside Telehealth: The Drug Enforcement Administration (DEA) Signals It's Open To Revising Telehealth Rules (5/22) - The DEA recently issued a temporary extension of pandemic telehealth prescribing flexibility, noting that the agency would work in concert with the Substance Abuse and Mental Health Services Administration (SAMHSA) to issue one or more final rules on the telehealth prescribing of controlled substances. Telehealth organizations, such as the Alliance for Connected Care, held multiple meetings with the White House Office of Management and Budget (OMB) and the DEA in early May to discuss issues they have with DEA’s proposed rule and called for the agency to promulgate safer and more patient-focused rules before the temporary extension rule came out.
Politico Pro: Medicare Contractors Will Keep Paying for Remote Monitoring (5/22) - Private insurance companies working for Medicare have decided they’ll continue to pay for devices that monitor patients’ vital signs from their homes. A group of the insurers, Medicare Administrative Contractors serving fee-for-service patients, had convened earlier this year to examine evidence to determine whether continued coverage was reasonable and necessary. The decision is a significant win for the telehealth industry, which argues that remote monitoring will yield cost savings by helping doctors catch health problems earlier. A number of key industry groups, including the Alliance for Connected Care, had pushed for continued coverage.
"We look forward to engaging in an evidence-based process with policymakers to ensure RPM and RTM are appropriately reimbursed and that these tools can support the care delivery models of the future," said Krista Drobac, executive director of the Alliance for Connected Care.
Health Resources & Services Administration (HRSA): Optimizing Virtual Care (5/23) - HRSA released a series of briefs regarding the Optimizing Virtual Care (OVC) program and health center experiences and strategies related to virtual care implementation. FY 2022 OVC one-time funding is part of the Health Center Quality Improvement Fund (QIF), which is a unique funding opportunity that supports health centers to pilot and test new ideas such as virtual care. The briefs are comprised of OVC Implementation Toolkit materials, providing virtual care support to health centers that can be adapted across the Health Center Program.
HRSA Office for the Advancement of Telehealth: Interstate Licensure Resources (5/23) - The HRSA Office for the Advancement of Telehealth released new interstate licensure resources. These resources include the latest guidance on how to practice telehealth across state lines legally and ethically while encouraging the uptake of licensure models that increase access to health care.
Inside Telehealth: CMS Reverses Course, Allows Virtual Supervision of Telehealth Visits By Residents (5/23) - CMS provided formal and informal guidance, exercising enforcement discretion and allowing teaching physicians to virtually supervise residents’ telehealth visits until the end of 2023 while the agency completes further rulemaking. The extension aligns with the broader expansion of virtual supervision for all provider types that lasts through the end of the year. Employees of Johns Hopkins Medicine, an Alliance board member, and a telehealth policy expert told Inside TeleHealth they thought ending virtual supervision of telehealth visits by residents was likely an oversight on the part of CMS and a result of the complicated untangling of pandemic-era waivers rather than an intentional decision.
White House: A Proclamation on National Hepatitis Testing Day, 2023 (5/18) - President Biden released a proclamation on National Hepatitis Testing Day. In the proclamation, he urges Americans to get tested. Additionally, President Biden highlights the Administration's budget request for FY2024, which includes a funding request to expand mobile, telehealth, and community sites focused on hepatitis testing and care, among other areas.
Inside Telehealth: House Pursues National Broadband Strategy; Senate Eyes Effective Broadband Programs (5/24) - House Republicans are pushing for a national, coordinated plan for expanding broadband to unserved and underserved areas using the billions of dollars already allocated across more than 100 federal and state agency programs. Senators are sifting through the overwhelming number of broadband programs and legislation to target which programs would be most effective in expanding internet access for telehealth use. Lawmakers in both the Senate and House are committed to pursuing broadband legislation to prevent deployment errors that have plagued the Federal Communications Commission and National Telecommunications and Information Administration for decades.
mHealth Intelligence: Legislation Aims to Support Telehealth Access in Rural Areas (previously reported)(5/24) - Earlier this month, a group of six House Members introduced the Protecting Rural Telehealth Access Act, which intends to maintain regional telehealth access and Medicare coverage flexibilities enacted during the COVID-19 pandemic. The expansion of telehealth that took place during the COVID-19 pandemic helped boost access to care, including in rural areas. The Protecting Rural Telehealth Access Act aims to save time and money for rural patients by making permanent Medicare telehealth coverage temporarily enacted during the pandemic.
Telehealth Research, Reports and Surveys
Annals of Family Medicine: The Telemedicine Experience in Primary Care Practices in the United States (5/24) - The need to rapidly implement telemedicine in primary care during the COVID-19 pandemic was addressed differently by various practices. Using qualitative data from semi-structured interviews with primary care practice leaders, the researchers of this study identified four overarching themes, including a need for more explicit telehealth visit triage guidelines following the COVID-19 public health emergency. The study adds to research surrounding telehealth use within the primary care arena in the US. For additional coverage, see Medical Economics and mHealth Intelligence.
Association of Community Cancer Centers: Digital Tools in Cancer Care (5/23) - The Association of Community Cancer Centers conducted a survey, which found that providers, patients, and caregivers were willing to utilize digital, remote patient-monitoring (RPM) tools to report symptoms throughout anti-cancer treatments. Key survey results found more than half (60 percent) of providers who implemented an RPM program said it added “10 hours or less” to a weekly workload. Of the 60 percent, almost half (40 percent) said the program did not “significantly disrupt workflow,” with 24 percent noting the technology actually improved workflow. For additional coverage, see Healthcare Innovation.
Health Services Research: State Medicaid and Private Telemedicine Coverage Requirements and Telemedicine Use (5/18) - Medicaid coverage of telehealth services between 2013 and 2019 was associated with significant increases in telehealth use and health care access. Medicaid telehealth coverage requirements were linked to a 6.01 percentage-point increase in the use of live video communication. Additionally, states with a Medicaid telehealth coverage requirement throughout the study period had substantially higher rates of telehealth use initially than those that added a policy. Access to covered telemedicine services could alleviate some of these barriers by eliminating the need to travel to see a provider, which may explain in part the larger response to telemedicine coverage among Medicaid enrollees. For additional coverage, see mHealth Intelligence.
JAMA Health Forum: Overall and Telehealth Addiction Treatment Utilization by Age, Race, Ethnicity, and Socioeconomic Status in California After COVID-19 Policy Changes (5/19) - This cohort study found that disparities in addiction treatment utilization were not exacerbated following expansion of telehealth during the early phase of the COVID-19 pandemic. Researchers examined whether there were differences in overall and telehealth addiction treatment utilization after telehealth policy changes during the COVID-19 pandemic by age, race, ethnicity, and socioeconomic status. Additionally, the findings show that the odds of initiating addiction treatment via telehealth rose by 38.5 percentage points between 2019 and 2020. For additional coverage, see mHealth Intelligence.
Telehealth News and Market Developments
Healthcare IT News: A Deep Dive Into PrimaryOne Health's Virtual Care Journey (5/23) - PrimaryOne Health, a federally qualified health center, describes how telemedicine capabilities were built up from scratch to become an important part of practice. PrimaryOne Health provides comprehensive primary and preventive health care services for uninsured, underinsured and other medically underserved central Ohio residents. Prior to the pandemic, PrimaryOne Health dealt with regulations that prevented routine telemedicine visits with patients. Today in the medical group, telehealth is a popular option with established practitioners who have a panel of patients.
Healthcare IT News: Telehealth Helps Reduce Depression in Youth (5/22) - The Texas Child Mental Health Care Consortium (TCMHCC) is a primary care access program that facilitates consults for primary care physicians and a school-based telehealth access program for direct intervention for students. More than 60 percent of children with major depression in the U.S. do not receive any treatment. The program aims to treat more patients within the primary care setting while creating a formal process through which primary care physicians can reach out to psychiatrists and therapists for mental health assistance with their patients. This alignment happened due to Texas legislation that required providers and agencies throughout the state to work together.
State Telehealth News
Nevada Current: Legislature Approves Permanent Expansion of Telehealth Services (5/26) - The Nevada Legislature passed Senate Bill 119, which would continue telehealth access by requiring third-party insurers to cover telehealth at the same rates as in-person care. The vote in favor of SB 119 was unanimous in both houses, except for one member of the assembly who was excused. SB 119 requires insurance to pay the same amount for telehealth services as in-person services if the care is delivered to patients in rural areas, by certain health care facilities, or for counseling and treatment related to a mental health condition or substance use disorder, including services delivered through an audio-only telehealth interaction; and are provided to patients on or after July 1, 2023.
KQ2: Telehealth Helps Rural Missourians Access Mental Health Services (5/24) - Telehealth is a treatment option that is becoming more common for rural Missourians seeking mental health help. Missouri has the largest shortage of providers in the U.S. Telehealth gives rural residents more choices in health care providers and may cut down on the need to take time off work or obtain child care, saving patients money and time. The University of Missouri Extension coordinates with the North Central Farm and Ranch Stress Assistance Center and the Missouri Department of Agriculture to provide telehealth sessions for farmers, ranchers and their immediate family members.
Observer Reporter: Telehealth Widens Access to Mental Health Services (5/22) - Chestnut Ridge Counseling, a counseling provider in Pennsylvania, turned to telehealth to virtually reach rural clients and those otherwise unable to make in-person mental health appointments. Regulations during the COVID-19 pandemic allowed the counseling provider to provide telehealth for psychiatric services to those within an hour’s drive to Chestnut Ridge. Chestnut Ridge saw 97 percent of their patients virtually after the pandemic began. “There were people that were isolated and lacking supports and needing some help. I think both of those things played into an increase of need for services,” said David Artis, chief operating officer.
Politico Pulse Check, "Medicare Contractors Will Keep Paying for Remote Health Monitoring." Private insurers will continue coverage for remote patient monitoring devices through Medicare, signaling a significant win for the telehealth industry. Host Megan Messerly talks with Ben Leonard about the decision, which may reduce spending in the program.
Association of Community Cancer Centers, "Key Highlights from an ACCC Survey on Remote Patient Monitoring." In 2022, ACCC conducted a survey to measure patient, caregiver, and provider perceptions and adoption of messaging tools, electronic questionnaires, and connected devices used to track and monitor symptoms during cancer treatment. This podcast shares key survey findings.