While the final bill does include an expansion of Medicare telemental health services, it does so with an in-person visit requirement. Please note that the 1-year extension of telehealth flexibility was not included – so we continue to renew the public health emergency in 90-day increments. The next renewal is expected on January 20.
An expansion of access to telemental health services in Medicare that would allow beneficiaries to receive mental health services via telehealth, including from the beneficiary’s home. To be eligible to receive these services via telehealth, the beneficiary must have been seen in person at least once by the physician or non-physician practitioner during the six-month period prior to the first telehealth service, with additional face-to-face requirements determined by the Secretary. NOTE – we do not expect this provision would go into effect until after the Public Health Emergency ends.
While this provision would expand access to tele-mental health care, we are very disappointed to see an in-person requirement added to statute. Years of telehealth advocacy have been devoted to removing these restrictions. Adding an in-person requirement prevents people that are homebound, transient, or have existing healthcare access challenges from using telehealth – really negating so much of the value that telehealth creates in helping people that NEED expanded access to care.
The addition of $249,950,000 in funds for the COVID–19 Telehealth Program at the Federal Communications Commission to help health care providers provide connected care services to patients at their homes or mobile locations in response to the COVID-19 pandemic.
Report language on Remote Prescribing of Controlled Substances. The Drug Enforcement Administration is directed to complete the requirements under section 3232 of the SUPPORT for Patients and Communities Act (Public Law 115-271) to promulgate regulations clarifying the limited circumstances in which Special Registration for Telemedicine may occur under the Ryan Haight Act (Public Law 110-425). DEA is further directed to brief the Committees on the status of these regulations not later than 30 days after the date of enactment of this Act.
Medicare Payment for Rural Emergency Hospital Services. A new, voluntary Medicare payment designation that allows either a Critical Access Hospital (CAH) or a small, rural hospital with less than 50 beds to convert to a Rural Emergency Hospital (REH) to preserve beneficiary access to emergency medical care in rural areas that can no longer support a fully operational inpatient hospital. REHs can also furnish additional medical services needed in their community, such as observation care, outpatient hospital services, telehealth services, ambulance services, and skilled nursing facility services. REHs will be reimbursed under all applicable Medicare prospective payment systems, plus an additional monthly facility payment and an add-on payment for hospital outpatient services.
Telehealth Centers of Excellence (COE). The agreement includes $6,500,000 for the Telehealth COE awarded sites. The agreement directs HHS and HRSA to continue to utilize the expertise of the COEs in the Ending the HIV Epidemic initiative to develop best practices for utilizing telehealth in HIV prevention, care, and treatment.
Telehealth Evaluation. The agreement provides $1,000,000 to support a comprehensive evaluation of nationwide telehealth investments in rural areas and populations, as described in House Report 116-450.
Opioid Abuse in Rural Communities. The agreement encourages SAMHSA to support initiatives to advance opioid abuse prevention, treatment, and recovery objectives, including by improving access through telehealth. SAMHSA is encouraged to focus on addressing the needs of individuals with substance use disorders in rural and medically underserved areas. In addition, the agreement encourages SAMHSA to consider early interventions, such as co-prescription of overdose medications with opioids, as a way to reduce overdose deaths in rural areas.
The Guardian: (1/2) – The pandemic has accelerated some trends, such as the one to a “hospital without walls” – the hospital conceived as a digitally connected community rather than a circumscribed physical space. The twin pillars of digital health are electronic health records (EHRs), which allow patient information to be shared across health systems, and telehealth, which allows patients and physicians to communicate at distance.
HHS Telehealth Innovation Summit: (12/22) – On December 22, several Alliance members including Amwell and Intermountain Healthcare participated in a HHS Telehealth Innovation Summit where telehealth leaders shared challenges and opportunities they face in reimbursement, best practices, public-private partnerships, healthcare resilience, biosecurity and the future of telehealth.
State Telehealth News
mHealth Intelligence: (12/29) – California State Assemblywoman Cecilia Aguiar-Curry introduced AB 32 earlier this month, which would indefinitely extend the emergency provisions enacted during the public health emergency by making expanded telehealth coverage permanent in the Medi-Cal program. The bill, which will be debated next month, would also call for an analysis and report on the benefits of telehealth in the Medi-Cal program to be completed by June 2025.
Kaiser Family Foundation: (12/23) – KFF released a new brief with results from focus group interviews conducted with 16 state and regional Primary Care Associations, outlining how health centers have adapted service delivery models to respond to COVID-19 and meet patient needs. The study found that while rapidly pivoting to telehealth was key for health centers to continue seeing patients and staying financially solvent during the pandemic, many patients faced technology or cultural barriers that prevented them from accessing telehealth services.
The Boston Globe: (12/22) – Lawmakers in the Massachusetts House and Senate reached a deal on a bill containing several telehealth provisions to increase access to care in the state. The bill extends emergency requirements implemented during COVID-19 by mandating health plans to cover telehealth services in any case where in-person services would be covered. The bill would also require permanent payment parity for behavioral health services delivered via telehealth, as well as payment parity for the next two years for primary care and chronic disease management services delivered via telehealth.
Fierce Healthcare: (12/22) – NYU Langone in New York City leveraged its telehealth platform and bedside digital tools to adapt to a new way of delivering care during the COVID-19 pandemic. The health system scaled up its inpatient virtual health platform, MyWall, using its existing technology and operational infrastructure to be used as a tool for virtual visits across the system’s inpatient facilities.
Virginia Mercury: (12/22) – This op-ed outlines how telehealth expansions in the Commonwealth of Virginia have been transformative for how patients access care throughout the pandemic. The article outlines recommendations for how to build on this progress, including continuing to fund local broadband expansions, conducting a telehealth study on outcomes, and continuing to revise regulations to increase access and reduce barriers in accessing telehealth across the state.
EHR Intelligence: (12/21) – The Idaho Health Data Exchange (IHDE) integrated a remote patient monitoring program to improve patient care and boost telehealth services across the state. The goal of the platform was to implement a telehealth alternative for patients to access remote preventative, routine, and chronic care in order to improve safety for older patients or those who live far from their providers during the pandemic.
Healthcare IT News, “Top 10 HIMSS TV Videos of 2020.” From interoperability to patient engagement and experience, the interviews and topical deep-dives of HIMSS TV multimedia features gained a wide audience in 2020. Here is a recap of the top 10 videos of the year.