Alliance for Connected Care: Alliance for Connected Care Applauds the House for Advancing Telehealth Coverage for Seniors (7/27) – The Alliance for Connected Care applauded House lawmakers for their commitment to protecting telehealth access through the passage of the Advancing Telehealth Beyond COVID-19 Act of 2022 (H.R. 4040). This legislation would ensure that Medicare beneficiaries continue to have access to telehealth until at least December 31, 2024. “We are pleased to see the House of Representatives taking action to reduce ambiguity around the future of telehealth in Medicare,” said Krista Drobac, Executive Director of the Alliance for Connected Care. “This legislation will protect crucially needed patient access to care while allowing policymakers to comprehensively analyze telehealth expansion data to permanently expand telehealth for seniors.”
Modern Healthcare: House Passes Bill Extending Telehealth Reimbursement Through 2024 (7/27) – The House of Representatives passed the Advancing Telehealth Beyond COVID-19 Act of 2022 (H.R. 4040). Following the vote, the Alliance for Connected Care and Telehealth Access for America, two health care advocacy groups, applauded the bill's passage.
Advancing Telehealth Beyond COVID-19 Act: (7/27) – The House passed by a vote of 416-12 the Advancing Telehealth Beyond COVID-19 Act of 2022 (H.R. 4040). This bill would extend through December 31, 2024 critical telehealth policies implemented during the COVID-19 pandemic to make it easier for Medicare beneficiaries to access remote care via telehealth. This includes:
Continuing Medicare flexibility around geographic requirements and originating sites.
Allowing additional practitioners to provide telehealth services; extending payment for Federally Qualified Health Centers and Rural Health Clinics.
Allowing audio-only telehealth services to continue.
Allowing recertification of eligibility for hospice care.
Delaying the implementation of in-person visit requirements prior to the delivery of mental health services through telehealth.
This bill was supported on a bipartisan basis, however during debate and following the bill’s passage in a press release, Republicans noted that more could have been done to improve the bill (such as including a provision to provide pre-deductible coverage of telehealth services for individuals with high-deductible health plans coupled with a health savings account), and advocated for permanent expansions of telehealth services. Information before the House Rules Committee, including proposed amendments that were not ultimately adopted, can be found here. CBO ScoreGOP Ways & Means Statement
Committee on Ways & Means: House Health Leaders Praise Inclusion of Ways and Means, Energy and Commerce Telehealth Expansions (7/27) – Republican Members of the House Ways & Means Committee and the House Energy & Commerce Committee introduced several pieces of legislation that would make permanent certain expansions of telehealth services:
On July 26, Reps. Schweikert (R-AZ), Miller-Meeks (R-IA), and Carter (R-GA) introduced H.R. 8489, which would extend certain telehealth services and requirements. Press Release
Also on July 26, Reps. Kelly (R-PA), Guthrie (R-KY), and Valadao (R-CA) introduced H.R. 8491, which would expand eligible practitioners to furnish telehealth services. Press Release
Also on July 26, Reps. Buchanan (R-FL), Johnson (R-OH), and Steel (R-CA) introduced H.R. 8493, which would remove geographic requirements and expand originating sites for telehealth services.
Also on July 26, Reps. Hern (R-OK), Curtis (R-UT), and Bacon (R-NE) introduced H.R. 8497, which would remove in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology. Press Release
Also on July 26, Rep. Miller (R-WV) introduced H.R. 8505, which would permit the use of telehealth for purposes of recertification of eligibility for hospice care. Press Release
Also on July 26, Reps. Murphy (R-NC), Burgess (R-TX), and Herrell (R-NM) introduced H.R. 8506, which would extend telehealth services for federally qualified health centers and rural health clinics. Press Release
Also on July 26, Reps. Smith (R-MO) and Flores (R-TX) introduced H.R. 8515, which would allow for the furnishing of audio-only telehealth services. Press Release
Rep. Adrian Smith (R-NE): Letter Calling for Continued Flexibility on the Critical Access Hospital 96-hour Admission Rule (7/21) – Rep. Smith (R-NE) and 24 House members sent a letter to HHS regarding their concerns about Critical Access Hospitals’ (CAHs) ability to continue providing high quality care to rural Americans after the COVID-19 Public Health Emergency (PHE) expires. While many PHE flexibilities helped CAHs weather the impacts of the pandemic, including those that allowed CAHs on a temporary basis to serve as a distant site provider for telehealth and offer services the same way they do for in-person care, waiving and deprioritizing enforcement of the 96-hour condition of payment rule has brought certainty to CAH operations, both before and during the pandemic.
Department of Health and Human Services: HHS and DOJ Issue Guidance on Nondiscrimination in Telehealth the week of the 32nd anniversary of the Americans with Disabilities Act (ADA) (7/29) – The Department of Health and Human Services (HHS) and the Department of Justice (DOJ) released joint guidance on the protections in federal nondiscrimination laws, requiring that telehealth be accessible to people with disabilities and limited English proficient persons. These laws work in tandem to prohibit discrimination and protect access to health care. The guidance provides examples of actions that may be discriminatory and describes steps that providers may need to take to ensure that health care offered via telehealth is accessible. The guidance also provides a list of resources that providers and patients may wish to consult for additional information about telehealth and civil rights protections. See the DOJ press release here.
Centers for Medicare & Medicaid Services: CMS Seeks Public Feedback to Improve Medicare Advantage (7/28) – The Centers for Medicare & Medicaid Services (CMS) released a Request for Information seeking public comment on the Medicare Advantage (MA) program. CMS is asking for input on ways to achieve the agency’s vision so that all parts of Medicare are working towards a future where people with Medicare receive more equitable, high quality, and person-centered care that is affordable and sustainable. Specifically, CMS wants feedback on the role telehealth plays in providing access to care in MA, and how the agency could push for equitable access to telehealth. CMS also asks what policies within its existing authority it could use to address access issues tied to limited broadband access.
Centers for Disease Control and Prevention: CDC Makes Monkeypox Treatment Available Via Telehealth (7/28) – The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) unveiled a streamlined process for health care providers to offer a smallpox antiviral treatment to patients who have monkeypox, which includes the option to prescribe the drug via telehealth. Under the CDC policy, all physician visits required to prescribe the drug can be conducted via telemedicine. For additional coverage, see Inside Health Policy.
Rural Utilities Service: Notice of Proposed Information Collection – Distance Learning and Telemedicine Loan and Grant Program (7/27) – The Rural Utilities Service's (RUS) Distance Learning and Telemedicine (DLT) Loan and Grant program provides loans and grants for advanced telecommunications services to improve rural areas' access to educational and medical services. The purpose of collecting the information is to determine such factors as eligibility of the applicant, the specific nature of the proposed project, the purposes for which loan and grant funds will be used, project financial and technical feasibility, and compliance with applicable laws and regulations.
White House: Statement of Administration Policy – Advancing Telehealth Beyond COVID-19 Act of 2022 (7/26) – The White House released a Statement of Administration Policy for the Advancing Telehealth Beyond COVID-19 Act of 2022 (H.R. 4040), stating that the Administration strongly supports this legislation. The statement noted that this bill would build on the experience and best practices learned during the pandemic, and modernize the health care system to expand access to quality, affordable care, especially in rural and underserved communities. The Administration urged the House to pass the bill, noting that it looks forward to working with Congress to improve health care access and quality for all Americans.
“Telehealth has become an evolving and common pathway for accessing healthcare, particularly as our society becomes increasingly digitized” - Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division
Telehealth Research, Reports and Surveys
American Journal of Psychiatry: Impact of COVID-19 Telehealth Policy Changes on Buprenorphine Treatment for Opioid Use Disorder (7/28) – According to this study, drug treatment of veterans with opioid use disorder increased during the first year of the pandemic. This suggests that the rapid shift from in-person to telehealth visits at Veterans’ Affairs (VA) medical centers enabled patients to access care despite COVID-related disruptions. The number of patients receiving buprenorphine continued to increase after the COVID-19 policy changes, but the delivery of care shifted to telehealth visits, suggesting that any reversal of COVID-19 policies must be carefully considered as it could prevent VA patients from receiving buprenorphine via telehealth. For additional coverage, see Stat News, U.S. News & World Report, and University of Michigan.
Annals of Internal Medicine: Telehealth Strategies for the Delivery of Maternal Health Care
(7/26) – Telehealth strategies to supplement or replace in-person maternity care may affect maternal health outcomes. The purpose of this rapid review was to evaluate the effectiveness and harms of telehealth strategies for maternal health care given the recent expansion of telehealth during the pandemic, and to produce an evidence map. The review found that replacing or supplementing in-person maternal care with telehealth generally results in similar, and sometimes better, clinical outcomes and patient satisfaction compared with in-person care. The effect on access, health equity, and harm is unclear.
Brookings Institute: The Roadmap to Telehealth Efficacy: Care, Health, and Digital Equities (7/25) – In this Brookings report, researchers propose flexibilities within the current health care system that accommodate the changes imposed by new technologies, as well as continued government incentives to drive more competitive options and alternatives for health care delivery. They also argue that government must continue to promote the use of remote health care and leverage national investments in broadband infrastructure to drive the complementary use of telehealth with traditional health care. Telehealth must be positioned and implemented in coordination with value-based payments to ensure patient access to meaningful care that can be bolstered and not substituted by existing and emerging health care technologies.
JAMA Internal Medicine: Effect of a Comprehensive Telehealth Intervention vs Telemonitoring and Care Coordination in Patients with Persistently Poor Type 2 Diabetes Control (7/25) – According to this study, a comprehensive approach to telemonitoring type 2 diabetes bolstered glucose control in tough-to-manage patients. The study found that, compared with telemonitoring/care coordination, comprehensive telehealth improved multiple outcomes in patients with persistently poorly controlled type 2 diabetes (PPDM) at a reasonable additional cost. This study supports consideration of comprehensive telehealth implementation for PPDM in systems with appropriate infrastructure and may enhance the value of telehealth experienced during the COVID-19 pandemic and beyond. For additional coverage, see MedPage Today.
NEJM Catalyst Innovations in Care Delivery: Telemedicine Is Mainstream Care Delivery (7/15) – In this recent survey, a majority of respondents credited telemedicine with improving patient health, providing good quality care and increasing access for vulnerable populations. However, the results also point to challenges that must be addressed as this field becomes more established. Of U.S. respondents, 71 percent reported that telemedicine has improved patient health, while a similar proportion said it provides at least moderate quality specialty or mental health care. For primary care, that share was 81 percent. When responses across all countries are included, the results differ only slightly from those of U.S. respondents. The responses demonstrate a clear need for telemedicine beyond the pandemic. For additional coverage, see Weill Cornell Medicine.
State Telehealth News and Activity
JD Supra: Office of Mental Health Publishes Emergency Rule Making for Telehealth
(7/28) – The New York State Office of Mental Health published an Emergency Rule Making related to telehealth services, the purpose of which is to establish regulations regarding the expansion of telehealth. These regulations would make permanent many of the flexibilities put in place during the COVID-19 pandemic. The effective date of the Emergency Rulemaking was July 12, 2022, and the comment period is open for 60 days. State Register Notice
Washington State Department of Health: New telehealth option launched to expand COVID-19 treatment access
(7/28) – The Washington State Department of Health (DOH) and its partners have launched a new telehealth option for patients to increase access to medication to treat COVID-19. The new option expands the Federal government’s Test to Treat initiative, making telehealth consultations available to everyone and not just those who are insured, and gives people at risk of severe disease another way to quickly access free treatment for COVID-19.
Washington State Hospital Association: New Telehealth Provision: Alaska HB 265 (7/27) – The Alaska House Bill 265 includes an out-of-state physician provision that will provide greater access to care for patients with a suspected or diagnosed life-threatening condition, such as cancer. Alaskans with this type of condition can have telehealth visits with out-of-state physicians as long as they have a referral from their Alaska-licensed physician.
Wisconsin Department of Health Services: Wisconsin Department of Health Services to Give $2.5 Million in Grants to Expand Access to Telehealth Services
(7/27) – The Wisconsin Department of Health Services (DHS) is working to expand access to mental health and substance use treatment. The DHS will give over $2.5 million in grants to 27 providers in order to improve telehealth programs. The goal is to remove location and technology barriers to important health care services. For additional coverage, see Channel 3000.
Healthcare IT News: MaineHealth Turned a COVID-19 Grant into a Permanent Telehealth Program (7/25) – MaineHealth was faced with patients who needed to stay connected with their primary care and specialist providers for acute and chronic needs during the pandemic. To solve for the need to provide care virtually, MaineHealth integrated virtual care services into its care ecosystem, which required identifying and purchasing the software and hardware solutions, implementing large education efforts for patients and care team members, and creating a process for quality assurance and analytics. MaineHealth was awarded $803,268 from the FCC telehealth award program, which provided the resources for them to afford the new work processes, modalities, and structures for the delivery of telehealth.
Becker’s Hospital Review: Kansas Hospital Launches Remote Patient Monitoring Program for Chronic Conditions (7/25) – Lawrence Memorial Hospital (LMH) in Kansas has launched a new remote patient monitoring program for patients with chronic and uncontrolled conditions. The program focuses on patients with, or at risk for, chronic or uncontrolled conditions like diabetes, hypertension and heart failure. LMH Health plans to extend the program to other diseases as more patients enroll in the program.
mHealth Intelligence: Using Telehealth to Expand Patient Access to Breastfeeding Support (7/22) – Through a new partnership, Trinity Health of New England is offering a virtual program to help boost access to breastfeeding support amid the pandemic and ongoing baby formula supply issues. The telehealth-enabled breastfeeding support program, launched at the end of June, connects pregnant women and new mothers to a nationwide network of lactation consultants. The company provides an online platform through which people can book same-day virtual visits with the consultants, who offer guidance on various topics, including the importance of proper latch, milk storage, pumping, increasing milk supply, weaning and any complications related to breastfeeding. The program has been rolled out at Mercy Medical Center in Springfield, MA, Saint Mary's Hospital in Waterbury, CT, and Saint Francis Hospital in Hartford, CT — the health system's birthing hospitals.
Telehealth News and Market Developments
Medical Economics: Improve Your Telehealth System (7/27) – One of the biggest challenges with telehealth is integrating electronic health records and existing clinical work flows for telehealth solutions. Recent strides in integrating various telehealth tools are making work flows more seamless. A recent study by Alliance board member Amwell showed that nearly one in four clinicians say video visit work flows are not at all or hardly integrated with their organization’s existing systems.
Healthcare IT News: How Telehealth Can Help Solve the Physician Specialist Shortage (7/27) – In this interview, Dr. Chris Gallagher, CEO of SCO Telemed, a large, multispecialty acute telemedicine practice, talks about the landscape of specialty care in telehealth. He also talks about which medical specialties lend themselves well to telemedicine, and what CIOs and CMOs at health care provider organizations today should know about delivering specialty care via telehealth.
mHealth Intelligence: PCORI Approves Millions in Funding for Virtual Chronic, Acute Care Research (7/27) – The Patient-Centered Outcomes Research Institute (PCORI) approved funding totaling $258 million dedicated to enhancing research and examining understudied areas of treatment for chronic and acute conditions related to mental and heart health, among others. Of the total funding, $72 million was provided for five studies promoting mental health, with two studies seeking to identify the differences between in-person and virtually operated screenings and to compare two strategies to reduce suicide rates.
Upper Midwest Telehealth Resource Center: Intel gives Intermountain funding to expand patient safety monitoring (7/26) – Alliance board member Intermountain Healthcare received a $100,000 grant from Alliance board member Intel to develop new remote monitoring capabilities in its hospitals. This grant will help fund 70 new camera systems for use in the Intermountain Patient Safety Monitoring program, giving caregivers an extra “set of eyes and ears” in rooms where patients may be at risk of falling or pulling out an IV or catheter. The cameras will be deployed across Intermountain hospitals and monitored from Salt Lake City.
Entertainment Focus: How Telehealth Helps People Access Medical Services (7/26) – For people who live in more rural or remote areas where health care isn’t as easy to access, telehealth makes it much easier to make and attend an appointment with various services. Rather than having to travel to appointments every time, patients can discuss their health needs remotely, only having to travel when it’s important that they’re seen in person. Telehealth also improves accessibility for people with other circumstances that could make it difficult for them to travel. This could be due to disability or either physical or mental health issues, or perhaps even other problems such as abusive or unstable home lives. Telehealth services and products mean that these people can make and complete appointments much more easily.
American Hospital Association: Letter to Senate Finance Committee on Discussion Draft Addressing Mental Health Care and Telehealth (7/19) – As the Senate Finance Committee works to establish telehealth regulations, the American Hospital Association (AHA) provided feedback aimed to optimize the expansion of virtual mental health services. The last several years have demonstrated the increasing need for mental health services before and during the COVID-19 pandemic. The letter spoke on behalf of 5,000 hospitals, 270,000 physicians, and two million nurses, many of whom treat mental health conditions. For additional coverage, see mHealth Intelligence.
Physician’s Weekly Podcast, “The Value of Telehealth.” Cerebrovascular neurosurgeon Dr. Peter Rasmussen, from the Cleveland Clinic in Ohio, speaks about the role of virtual second opinions and the cost savings associated with them. In the same episode, Professor Fatima Cody Stanford, an obesity medicine physician scientist at Massachusetts General Hospital and Harvard Medical, discusses how telehealth can both support and exacerbate health disparities.