Alliance News

Alliance COVID-19 Interim Final Rule Summary. The Alliance posted a summary of the key telehealth provisions the second interim final rule, which includes expanded types of practitioners that can furnish distant site telehealth services, increased [payment and additional audio-only codes, and allows Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to bill Medicare for telehealth. Additional details included in the below section.

The Alliance is Tracking Legislation. The page includes recent COVID-related legislation that the Alliance is tracking due to significant telehealth or remote patient monitoring provisions. We intend to continually updating this page during and beyond the COVID-19 public health emergency.

In the News:  Executive Director Krista Drobac was featured in a Progressive Policy Institute (PPI) conference call as well as Managed Healthcare Executive to discuss how Congress and the Trump Administration have reduced barriers to accessing telehealth and what states can do to increase access to telehealth services during the COVID-19 pandemic.

Federal Agency Telehealth Activity / Guidance

CMS Second Interim Final Rule and Blanket Waivers: (4/30) On April 30, the Centers for Medicare and Medicaid Services released another Interim Final Rule, implementing significant additional changes for telehealth. 

Specifically, this Interim Final Rule includes more changes created using the statutory authority of Coronavirus Aid, Relief, and Economic Security Act (CARES Act). These changes include both new 1135 waivers and the interim final rule – both explained in our summary document.

• CMS expanded the ability to practice telehealth services to all providers eligible to bill Medicare. This should fix concerns about physical therapists, occupational therapists, speech language pathologists, and others not being on the distant site provider list.
• CMS increased Medicare payment rates for the previously-created audio-only E&M codes, and made focused expansions of audio-only codes - listed in the summary. 
• CMS gave itself the authority to make future changes to the telehealth services list through sub-regulatory guidance.
• Rural Health Clinics and Federally Qualified Health Centers may bill Medicare for telehealth as per the CARES Act.
• Please find additional information and resources on our Interim Final Rule Summary page.

CMS: (4/27) – CMS Center for Consumer Information and Insurance Oversight (CCIIO) issued a FAQ clarifying which telehealth services are valid for data submissions for the HHS-operated risk adjustment program. 

HHS: (4/30) – HHS, through the Health Resources and Services Administration (HRSA), awarded $20 million to increase telehealth access and infrastructure for providers and families to help prevent and respond to COVID-19. The funds will also increase access to telehealth and assist telehealth providers with cross-state licensure.

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CMS has also newly updated many of its provider-specific guidance documents:

• Home Health Agencies 
• Physicians and Other Practitioners 
• Ambulances
• Hospitals
• Teaching Hospitals, Teaching Physicians and Medical Residents
• Long Term Care Facilities
• Hospices
• Inpatient Rehabilitation Facilities 
• Long Term Care Hospitals 
• Rural Health Clinics (RHCs and FQHCs) 
• Laboratories 
• End Stage Renal Disease Facilities 
• Medicare Advantage and Part D Plans 
  
• State Medicaid & Basic Health Programs 
• Medicare Shared Savings Program Participants 

Find older COVID-19 Telehealth Guidance on our regularly updated website.

Congressional Activity and Legislation

Emergency COVID-19 Telehealth Response Act (H.R. 6634): (4/28) – On April 28, Rep. Axne (D-IA) introduced the Emergency COVID-19 Telehealth Response Act, which would ensure that physical therapists, occupational therapists, speech pathologists, audiologists, and clinical social workers can receive telehealth reimbursement rates from CMS while providing necessary health services during COVID-19. 

Letter: On April 14, Reps. Fletcher (D-TX), Blunt Rochester (D-DE), Matsui (D-CA), and McKinley (R-WV) led a bipartisan letter to HHS Secretary Azar to expand the types of providers eligible to provide telehealth services under Medicare during the COVID-19 pandemic to include physical therapy practitioners, occupational therapy practitioners, speech-language pathologists, and audiologists. 

Health Care at Home Act of 2020 (H.R. 6644): (4/28) – On April 28, Reps. Schrier (D-WA), Morelle (D-NY) and Van Drew (R-NJ) introduced the Health Care at Home Act of 2020, which would require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person during the COVID-19 emergency.

Letter: (4/29) – Sen. Manchin (D-WV) and Capito (R-WV) led 37 Senators in a letter to HHS Secretary Azar and CMS Administrator Verma calling for equal reimbursement of audio-only telehealth to audio-visual and in-person visits. Press release

News and Reports

The Hill: (4/26) – Fears and anxiety about COVID-19 are highlighting the need for mental health care – an area telehealth is well suited to contribute to. However, laws, insurance coverage and public infrastructure need to catch up.

mHealthIntelligence: (4/26) – Dental care providers are seeking out telehealth to provide care during the COVID-19 pandemic. Teledentistry sites have offer some suggestions on how to shift services online.

Letter to FCC: (4/27) - The ADA sent a letter to FFC Chairman Pai to include dental practices in the COVID-19 Telehealth Program. ADA commented that video conference is an effective way to screen dental emergencies but said many dentists are facing economic burdens and need access to FCC funds in order to afford teledentistry costs.

Kaiser Health News: (4/27) – Cost-free telemedicine is not proceeding as smoothly as some had hoped – likely to a fragmented healthcare system – which encompasses insurers, state regulators and thousands of independent doctor practices.

CNBC: (4/27) - UnitedHealth Group’s Optum is in advanced talks to acquire virtual therapy provider AbleTo for roughly $470 million, at a time when telehealth is more in demand than ever.

HealthTech: (4/27) – Remote patient monitoring tools provide a range of benefits including helping providers track data, curb readmissions and improve outcomes after a patient’s discharge. According to a recent report, 88 percent of healthcare providers have invested in – or are evaluating – RPM technologies to support high-risk, chronically ill patients at risk for hospital readmission.

STAT News: (4/29) – Telemedicine during the pandemic is more than just a convenience for patients in rural areas with chronic conditions – and patients are finding they need telehealth expansions to stay.

American Medical Association: (4/29) – AMA’s Senior Assistant Director for Federal Affairs said that there will be changes in the practice of telemedicine and AMA is, “definitely going to be pushing for some of these new [telehealth] policy flexibilities to remain in place.”

mHealthIntelligence: (4/29) – Christiana Care, one of the first to receive funding from the FCC’s COVID-19 Telehealth Program, is using the money to purchase RPM devices and data plans, expand telehealth services in underserved parts of Delaware and ensure broadband infrastructure for a home-based connected health program.

The Hill: (4/30) – During a virtual event, Reps. Matsui (D-CA) and Johnson (R-OH) highlighted the benefits of telehealth and expressed their support for enhanced access to telehealth beyond the COVID-19 pandemic.

BioSpace: (4/30) – Current Health is launching a collaboration with Mayo Clinic to develop RPM solutions to accelerate the detection of COVID-19 positive patients and predict symptom and disease severity.

Morning Consult: (4/30) – An op-ed suggesting CMS make policy changes to allow American seniors to access physical therapy services via telehealth – with authority provided by the CARES Act.

STAT Morning Rounds: (5/1) – A new AARP poll found that 96 percent of the nearly 2,800 respondents support having nursing homes and other long-term care facilities enable video visits so residents could keep in touch with family – suggesting that older adults are increasingly supportive of virtual technologies.

Upcoming Events –

May 5 – Patient-Centered Outcomes Research Institute, “Confronting COVID-19: Finding Hospital Capacity and Improving Patient Flow; Part 6 - The Changing Role of Telehealth.” Webinar

May 6 – Louisiana Hospital Association, “Telehealth – During and After COVID-19.” Webinar

May 12 – University of Arizona Life Sciences, “Telemedicine During a Pandemic.” Webinar

Please send any news or events to cadamec@connectwithcare.org for inclusion in this newsletter.