Politico Pro: States' Experiment Helps Make Case for Easing Cross-State Licensure Rules (3/22) - A report from Cicero Institute found that telehealth did not spark more patient concerns than in-person care (read more in the research section). Many states waived licensing rules during the pandemic to allow their residents to meet with out-of-state doctors via telemedicine, and are now grappling with whether to continue to permit it. Telehealth lobbying groups like the Alliance for Connected Care have asked states to treat medical licenses like they do driver’s licenses, recognizing each other’s.
Alliance for Connected Care: Alliance Submits Comments in Response to the Senate HELP Committee Workforce RFI (3/20) - The Alliance for Connected Care submitted comments in response to the request for information from the Senate HELP Committee on the drivers of the health care workforce shortage. The Alliance specifically outlined the important role that telehealth can play in addressing health care workforce shortages moving forward and why telehealth should be included in any legislative action on this issue to ensure a comprehensive approach to bolstering the health care workforce nationwide.
Call to Action on the DEA's Proposed Telehealth Restrictions
The DEA recently issued a proposed rule, limiting the circumstances under which telehealth practitioners may prescribe controlled medications. We are extremely concerned that the rule as written interferes with the practice of medicine and will disrupt relationships between a huge number of patients and their telehealth providers.
Rep. Doggett (D-TX): Doggett Introduces New Legislation to Prevent Medicare Fraud (3/23) - Rep. Doggett (D-TX), Ranking Member of the House Ways and Means Committee Health Subcommittee, introduced two bills to prevent Medicare fraud:
The Medicare Fraud Detection and Deterrence Act (H.R. 1745), which would strengthen health care waste, fraud, and abuse provisions.
The Preventing Medicare Telefraud Act (H.R. 1746), which would establish requirements for the provision of certain high-cost durable medical equipment and laboratory testing.
Senate Finance Committee: The President's Fiscal Year (FY) 2024 Health and Human Services (HHS) Budget (3/22) - The Senate Finance Committee held its hearing on the President's FY 2024 HHS budget. During the hearing, HHS Secretary Becerra emphasized the importance of cross-state telehealth care.
"We want to make sure that everyone can use a doctor wherever that doctor is located. That requires the states to work with us to make sure we might be at across state borders. You'll have access through telehealth."
Additionally, Ranking Member Crapo (R-ID) highlighted the importance of sustainable telehealth access in his opening remarks and noted that he and Chair Wyden (D-OR) are "working very closely together" on permanent telehealth legislation. For additional coverage, see Inside Telehealth.
Sign-On Opportunity: Ask Congress to Support Telehealth Resource Centers in FY2024
We invite your organization to sign on to a letter asking Congressional Appropriators to include a $14 million request for the Telehealth Resource Centers (TRC) program at the Health Resources and Services Administration (HRSA) in FY2024 appropriations.
This increase in funding would provide a critical boost to the TRCs, which saw an 800% increase in demand for telehealth assistance during the COVID-19 pandemic. The TRCs need at least $14M in funding in FY24 to ensure that each TRC (regional and national) can receive at least $1M each to continue to meet this demand and ensure that telehealth questions and issues can continue to be addressed.
Substance Abuse and Mental Health Services Administration (SAMHSA): Digital Access: A Super Determinant of Health (3/22) - Internet access is increasingly recognized as a “super determinant” of health. The pandemic prompted the increased use of telehealth for both behavioral health and physical health services which has led to conversations around digital exclusion and the equitable implementation of telehealth services. Telehealth has the potential to address gaps in mental health and substance use treatment, make treatment services more accessible and convenient, improve health outcomes, and reduce health disparities. But this is all dependent on broadband access.
Office for the Advancement of Telehealth: Direct-to-Consumer Care Best Practice Guide (3/21) - The Health Resources & Services Administration (HRSA) released a direct-to-consumer telehealth care best practice guide.
Telehealth Research, Reports and Surveys
Cicero Institute: Few Disciplinary Issues with Out-of-State Telehealth (3/22) - This report reviews the states of Florida and Idaho's out-of-state telehealth approach and found that there were no disciplinary actions with across-state-line telehealth. Additionally, there was a substantial and growing number of providers interested in providing out-of-state telehealth. Despite the attention telehealth has received during the pandemic, few states have implemented robust laws allowing out-of-state clinicians to provide care in their state. As policymakers review their current laws to best help their state be ready for another pandemic, or to improve access to affordable care, Florida and Idaho offer some lessons on across-state-line telehealth for them to consider.
NTT Data: Many People Still Unaware of Telehealth's Efficacy (3/21) - According to a survey from NTT Data Services, it is more likely that more patients will gravitate toward telehealth visits for things like filling prescriptions, addressing cold and flu symptoms, annual check-ups that don’t require in-office testing, and other non-life-threatening needs. Survey respondents also agreed or strongly agreed (67 percent) with the statement that they feel more comfortable in their home when they fell ill, compared to 43 percent who agreed or strongly agreed that they felt more comfortable in the hospital. For additional coverage, see Drug Topics.
Foley & Lardner: Special Registration for Controlled Substance Prescribing via Telemedicine without In-Person Medical Evaluation White Paper Analysis (3/20) - Foley & Lardner LLP, an international law firm, released a white paper analysis, which discusses the legal authority and statutory obligation of the Drug Enforcement Administration (DEA) to promulgate regulations specifying the circumstances in which a special registration may be issued, and more. Notably, it concludes:
“The recently released proposed rule does not satisfy DEA’s obligation as directed by the Ryan Haight Act and the SUPPORT Act to implement a telemedicine special registration process enabling practitioners to prescribe controlled substances via telemedicine without a prior, in-person medical evaluation
The DEA has the legal authority and duty to issue rules developing a special registration permitting a practitioner to prescribe controlled substances via telemedicine without conducting an in-person medical evaluation. The DEA should use its authority to fulfill its obligations under federal law.”
Telehealth News and Market Developments
New York Times: People Can’t Get Their A.D.H.D. Medicine, and That’s a Sign of a Larger Problem (3/25) - Since last August, America has been experiencing a severe shortage of Adderall and related stimulant medications used to treat attention deficit hyperactivity disorder. To make matters worse, the D.E.A. announced in February that it wants to end the pandemic-driven relaxation of telehealth rules that currently allow people who take drugs like stimulants and opioid treatment medications to get them regularly without requiring at least one in-person visit. These changes may seem unrelated, but they reflect an approach to drug policy that focuses on controlling supply — one that has backfired in fighting opioid addiction and overdoses and could lead to similar damage to people who use prescription stimulants.
STAT News: I Finally Got Used to Practicing Telepsychiatry (3/24) - In this blog post, Jessica Gold, a psychiatrist, shares her own experience practicing telepsychiatry. Specifically, she highlights that virtual visits have high rates of patient satisfaction, and reduce no-show rates, which can save time and money for both the provider and staff. Dr. Gold also shares her concerns about the in-person visit requirement for a prescription of controlled substances from the DEA's proposed rule.
Health Affairs: DEA Telehealth Proposal Brings Risks, Not Patient Protections (3/23) - You may have missed the US Drug Enforcement Administration’s (DEA) recent telemedicine proposal. Released on a Friday evening, the proposal aims to reinstate requirements that mental health patients have in-person visits to get prescriptions for certain psychiatric and addiction medications. It’s becoming alarmingly common for government bodies to run interference on decisions between a patient and their doctor. Patients struggling with already stigmatized mental health conditions or addictions are clearly the next target.
Kaiser Health News: Mental Health Care by Video Fills Gaps in Rural Nursing Homes (3/21) - Video visits are an increasingly common way for residents of small-town nursing homes to receive mental health care. Patients don’t have to travel to a clinic. They don’t even have to get cleaned up and leave their bedrooms, which can be daunting for people with depression or anxiety. While use of some other telehealth services may dwindle as the COVID-19 pandemic winds down, providers predict demand for remote mental health services will continue to increase in rural nursing homes. For additional coverage, see McKnights Senior Living.
PR Newswire: Careington Expands Telehealth Programs to Include Virtual Primary Care and Psychiatry (3/21) - Careington International Corporation announced the expansion of telehealth programs offered through affiliate company DialCare to include virtual primary care and psychiatry, virtually connecting individuals to board-certified primary care physicians and psychiatrists nationally. The DialCare Physician Access program includes DialCare Urgent Care, a service offering 24/7/365 video and phone access to licensed physicians for non-emergency care. With the addition of Virtual Primary Care, members can establish a relationship with a dedicated primary care physician for their comprehensive, long-term virtual care of chronic health conditions.
MedCity News: ‘The Stakes Couldn’t Be Higher’: How DEA’s Proposal Will Affect Telehealth Controlled Substance Prescribing (3/21) - The DEA recently released proposed rules that would require an in-person visit before a patient can receive a telehealth prescription for a controlled substance. The DEA touts the change as a way to ensure patient safety, but several telehealth advocates argue it will greatly disrupt access for those who need the drugs — especially at a time when the mental health and substance use crisis is growing.
Healthcare IT News: Telemedicine Will Become Default, With More Virtual Treatments (3/20) - Sean Mehra, CEO and cofounder of HealthTap, a virtual-first urgent care and primary care clinic, predicts the next 10 years of virtual care. Mehra discusses whether virtual-first is the way to go, what the impending end of the public health emergency means for virtual care, how patients implementing technology into their healthcare routines can help and where telehealth will be in five and 10 years.
Becker's Hospital Review: What Health System Digital Executives Expect Next From Best Buy in Health Care (3/20) - Best Buy has begun partnering with hospitals and health systems to treat patients in the comfort of their homes. Through their Current Health partnership, Best Buy can use their technology in newer care models, especially for remote patient monitoring, avoiding the exorbitant costs of hospitals.
The Business Journals: Telehealth Startup Takes Aim at Chronic Allergy Systems with New Service (3/20) - A San Francisco telehealth startup is trying to help chronic seasonal allergy sufferers breathe more easily with customized nasal sprays, and the company has raised new funding. Allermi was founded in 2021 and now has six full-time employees on the operational side, as well as around 20 physicians that are licensed to provide telehealth services in all 50 states. They review intake questionnaires from patients to assess which types of allergy medications should be combined, or compounded, by Allermi's pharmacy partners.
State Telehealth News
Akron Beacon Journal: Expanded Telehealth Ambulance Pilot Program Could Ease Loads (3/22) - City of Akron Fire Department emergency crews in August will have to take over transporting all patients to area ERs. The fire department is in a pilot program with Akron General to provide a telehealth doctor for non-emergency situations. Expanding the pilot with other hospitals could help ease Akron's burden.
The Wayne Stater: Wayne State College Rolls Out Telehealth Counseling for All Students and Staff (3/21) - Wayne State College announced its Therapy Assistance Online (TAO) for all students and staff. TAO, based out of Florida, has several modules students could follow for educational support with mental wellness and receive encouragement for self-help practices. Topics include coping with anxiety or depression, learning resilience, mindfulness, time management and more. TAO also has several logs and journals along with their sessions where users can keep track of their learning and mental health.