Please find below the latest developments in federal and state virtual care policy as well as research, data, and polling on the use of virtual care.
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Alliance News
Uniform Law Commission: ULC Releases Model Legislation for Interstate Telehealth (7/13) – The Uniform Law Commission (ULC) introduced a model telehealth law on July 13 that, among other provisions, would create a consistent definition of telehealth and create a streamlined registration system for out-of-state telehealth providers to practice across state lines in states that adopt the model legislation. The ULC intentionally incorporated feedback from a diverse array of groups and federal entities in drafting the model legislation in order to make it attractive to state legislatures. Krista Drobac, executive director of the Alliance for Connected Care, served as an observer during this process and provided guidance on telehealth and licensure policy for the ULC model legislation drafters. For additional coverage, see Inside Telehealth.
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Administration
White House: Vice President Harris Marks Important New Milestone in Administration’s Efforts to Cut Costs for American Families (7/21) – The Biden Administration announced that, since the launch of GetInternet.gov in May, one million new households have signed up for the Affordable Connectivity Program (ACP). The program ensures that every American has access to reliable and affordable high-speed internet to ensure they can connect to services such as telehealth visits. Vice President Harris called on the nation’s governors to join the Administration’s enrollment drive.
Department of Justice: Justice Department Charges Dozens for $1.2 Billion in Health Care Fraud (7/20) – The Department of Justice announced criminal charges against 36 defendants in 13 federal districts across the United States for more than $1.2 billion in alleged fraudulent telemedicine, cardiovascular and cancer genetic testing, and durable medical equipment (DME) schemes. The coordinated federal investigations with the HHS Office of Inspector General (OIG) primarily targeted alleged schemes involving the payment of illegal kickbacks and bribes by laboratory owners and operators in exchange for the referral of patients by medical professionals working with fraudulent telemedicine and digital medical technology companies. The charges were regarding fraudulent claims by telemedicine companies, and not the telehealth service itself. The OIG released a Special Fraud Alert, which provides guidance to help providers identify potentially suspect arrangements with telemedicine companies. The Special Fraud Alert is not intended to discourage legitimate telehealth arrangements.
Home Health Care News: CMS Administrator Chiquita Brooks-LaSure Reemphasizes Telehealth Services Care (7/19) – On July 19, the U.S. Centers for Medicare & Medicaid Services (CMS) took the time to map out the federal agency’s strategic plans and key initiatives moving forward during a national stakeholder call. CMS Administrator Chiquita Brooks-LaSure and others highlighted telehealth and virtual care as a vital tool for providers. The Center for Program Integrity, in particular, will continue to combat Medicare and Medicaid fraud related to telehealth, telemedicine, and COVID-related fraud.
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Congress
House Committee on Rules: Meeting Announcement for Advancing Telehealth Beyond COVID-19 Act of 2021 – The House Committee on Rules announced it will hold a markup of the Advancing Telehealth Beyond COVID-19 Act of 2021 (H.R. 4040) on July 26, 2022. The bill would extend and codify critical telehealth policies implemented during the pandemic under the Medicare program while also making it easier for seniors – especially those in rural areas – to access emerging health care technologies. See here for the Rules text and text of the bill as introduced. For additional coverage, see Inside Health Policy.
Uncap America Act (7/21) – Sens. Lujan (D-NM) and Booker (D-NJ) introduced the Uncap America Act (S. 4590), which would provide requirements relating to data caps on broadband internet access service. The bill would prohibit data caps that force families to pay high costs and unnecessary fees to access high-speed broadband, require data caps to only be used for network management purposes, and direct the Federal Communications Commission (FCC) to hold providers accountable when they impose predatory data caps. Broadband access is critical to access services including telehealth. A summary of the bill can be found here
and the bill text can be found here.
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Telehealth Research, Reports and Surveys
The Journal of Rural Health: Contraceptive care service provision via telehealth early in the COVID-19 pandemic at rural and urban FQHCs (7/22) – The purpose of this study was to investigate telehealth use for contraceptive service provision among rural and urban federally qualified health centers (FQHCs) in Alabama and South Carolina during the initial months of the COVID-19 pandemic. The study found that, while telehealth for contraceptive care increased during this time period, fewer rural clinicals than urban clinics provided telehealth for contraceptive counseling, emergency contraception, and sexually transmitted infection care. Key facilitators of telehealth were reimbursement policy, electronic infrastructure and technology, and funding for technology. These differences highlight the need for supportive strategies to increase access to care for low-income rural populations.
MD Linx: Exercise delivered via telehealth is effective for chronic disease (7/19) –Telemonitoring with real time feedback from clinicians has been shown in other contexts to improve clinical markers, but this has not yet been evaluated for exercise in the chronic disease population. This study found that videoconferencing exercise interventions were effective at improving exercise capacity and quality of life. Furthermore, videoconferencing may be at least as effective as in-person interventions and superior to no intervention.
BMC Pregnancy and Childbirth: Experiences with use of technology and telehealth among women with perinatal depression (7/18) – This study aimed to understand women’s perspectives on telehealth services for perinatal depression. The study consisted of seven postpartum and ten pregnant women who shared their experiences using telehealth. Findings suggest that telehealth may be a reasonable and acceptable platform to increase access and retention for mental health services in childbearing women. Researchers also note videoconferencing delivery is an effective and affordable mental health service for low-resource communities.
JMIR Publications: Pandemic-Triggered Adoption of Telehealth in Underserved Communities: Descriptive Study of Pre- and Post-shutdown Trends (7/18) – This study explored whether the temporary shift to telehealth services has changed the attitudes toward the usage of technology-enabled health services in rural communities. The study found that the trend in telemedicine claims had an opposite pattern to that in non-telemedicine claims across the three time periods studied: pre-pandemic, pandemic before the rollout of mass vaccination, and pandemic after the rollout of mass vaccination. The current trends indicate that adoption of telehealth services is likely to increase post-pandemic and that consumers (patients), service providers, health care establishments, insurance companies, and state and local policies have changed their attitudes toward telehealth. An increase in the use of telehealth could help local and federal governments address the shortage of health care facilities and service providers in underserved communities, and patients can get the much-needed care in a timely and effective manner.
National Council for Mental Wellbeing: Innovations in Telehealth in Behavioral Health During COVID-19 (7/15) – The National Council for Mental Wellbeing released the “Innovations in Telehealth in Behavioral Health During COVID-19” report, which examined how the efficacy of telehealth services for mental health and substance use has differed among various populations. The report explored future considerations, including health equity, technology challenges, needs of special populations and rising provider burnout. For additional coverage, see the California Health Care Foundation.
EurekAlert: Telehealth enables eight Texas nurseries to reduce antibiotic use in newborns by 32 percent (6/29) – Researchers found that using telehealth to consult with pediatric infectious disease specialists can lead to a 32 percent decrease in antibiotic use in nurseries. Researchers began the study in 2018, prior to the start of the COVID-19 pandemic. In total, the nurseries cared for 9,277 babies over three years. They found that following the implementation of telehealth, the number of newborns receiving antibiotics dropped by 32 percent. This led researchers to believe telehealth can help lower antibiotic use among infants. For additional coverage, see mHealth Intelligence.
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State Telehealth News and Activity
NC Health News: Has telehealth democratized care? It’s complicated. (7/19) – Telehealth expanded access to care for many during the pandemic. Studies are finding that the keys to keeping that path open are flexibility and continued pandemic-era protections for remote visits. In North Carolina, telehealth has helped people from historically marginalized groups access care more often. The University of North Carolina found that after the federal expansion of telehealth, uninsured patients sought virtual care in greater proportions.
Forbes: Gas Prices Hurt People Going To The Doctor, But Interstate Telehealth Can Help (7/19) – Before the pandemic, some Americans were spending funds to cover 100 mile car rides just to see their doctors—and with today’s fuel inflation, some people are now spending an additional $60 in gas on top of the out-of-pocket costs they pay for their medical bills. Rising gas prices hit those who drive to access their doctors’ appointments the hardest. Unfortunately, when it comes to health care, patients driving the farthest tend to be people with the lowest incomes living in the most rural places. Interstate telehealth can help reduce the cost of visiting the doctor for rural residents, however, many states are restricting interstate telehealth.
Healthcare IT News: FCC and other awards helped enable permanent telehealth policy changes in Virginia (7/18) – The University of Virginia Health System was awarded $767,139 by the Federal Communications Commission (FCC) telehealth grant program for telemedicine carts, tablets, video monitors, a telehealth platform, remote patient monitoring equipment and network upgrades to support clinical videoconferencing with remote patient-examination tools. This grant will help build a virtual urgent care platform, and expand the remote patient-monitoring program as patients are diagnosed with COVID-19 or are discharged from the hospital.
Mobi Health News: Telehealth's role in combating the opioid epidemic (7/15) – In this interview with Bicycle Health, a company that provides opioid treatment through telehealth, CEO and founder Ankit Gupta discussed the treatment landscape for patients struggling with opioid use disorder. Gupta highlighted the new regulation in Alabama, which requires an in-person examination within the last 12 months to prescribe a controlled substance. “We had to literally fly a couple of providers to Alabama and spend a week there just to comply with the regulation so that we can continue taking care of the patients we have. We're not enrolling any new patients, but to continue taking care of the patients we have, until we find a suitable option for them on the ground. And so, there's just a massive, massive lack of access,” Ankit Gupta noted. For additional coverage, see Fierce Healthcare.
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Telehealth News and Market Developments
STAT News: As health care faces nursing shortages, burned-out nurses are flocking to remote jobs (7/21) – Nurses are beginning to step away from the bedside following burnout from the pandemic, with some seeking remote roles which have grown more popular as telehealth has taken off. Virtual nursing roles are highly competitive and often close within a few days of posting due to floods of applications. Two newer job titles are particularly growing with the rise of virtual care – chronic care management within both individual practices and larger companies, as well as virtual nursing roles within telehealth companies and brick-and-mortar care sites that want to increase their digital offerings. For some nurses, virtual work offers a career path that offers more flexibility and avoids mental burnout or injury.
Wall Street Journal: Amazon to Buy One Medical Network of Health Clinics in Healthcare Expansion (7/21) – Alliance member Amazon announced it will buy Alliance member One Medical in an effort to expand the company’s ability to offer medical services to a large pool of employers and individuals. Demand for telehealth during the pandemic increased the use of virtual care, which has fueled both growth of medical care outside of hospitals and patients regularly seeking care in more convenient and lower-cost settings. One Medical seeks to disrupt primary care and offers digital health and virtual care services, wellness-coaching apps and in-person visits. According
to Neil Lindsay, SVP of Amazon Health Services, “Together with One Medical’s human-centered and technology-powered approach to health care, we believe we can and will help more people get better care, when and how they need it.”
National Institute of Diabetes and Digestive and Kidney Diseases: How can you use telehealth to provide patient-centered diabetes care? (7/20) – This blog outlines the experiences of diabetic patients with telehealth, including the benefits and challenges of remote diabetes care. Evidence suggests that telehealth has led to higher engagement and self-efficacy for many people with diabetes. Patients found it empowering to connect with health care professionals from their homes, where they’re in charge.
The Washington Post: Gynecologists actually can see patients online. Here’s how and when. (7/19) – In this op-ed, an OB/GYN doctor provides their experience with telehealth in this specialty. The author notes that telehealth allowed them to review patients’ histories, address their more immediate health problems, discuss other relevant clinical information, renew or change their prescriptions, and email them an order for a yearly mammogram or a bone density test. Telehealth has also worked well for patients who have multiple responsibilities, such as aging parents, an ill spouse or partner who requires emotional support, and children to raise. Telehealth can provide patients the option to be screened from home to determine the severity of a problem, with either immediate reassurance and treatment virtually, or timely referral to an emergency facility. This can save anxiety, time and money for both the consumer and the health care system.
Healthcare IT News: Groups doubles down on telehealth with a mobile app to treat opioid addiction (7/18) – Groups, a value-based care provider of opioid-addiction treatment, has built an effective combination of telemedicine and connected health. The organization made the decision to close all 120 of its clinics across the country and transition to 100 percent virtual opioid-use-disorder treatment services. To accomplish this, Groups provided its members with a number of different digital health technologies that enable them to continue their treatment virtually and do all of the form submissions, drug screens and insurance processes that are part of the Groups recovery program virtually.
Medical Economics: Consider Jumping Into Remote Patient Monitoring (7/18) – The benefits of providing remote patient monitoring (RPM) services are substantial, widely acknowledged, and extend across the health care landscape. Used most effectively, RPM has the potential to help health care professionals care for millions of Americans with manageable chronic diseases, such as diabetes, obesity, and hypertension.
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Upcoming Events and Hearings
July 26 – House Committee on Rules, “Meeting to Markup the Advancing Telehealth Beyond COVID-19 Act of 2021 (H.R. 4040).”
July 27 – Healthcare Dive, “Planning a Telehealth Strategy Amid Regulation Uncertainty.”
August 9-10 – California Telehealth Resource Center, “The Golden State for Telehealth: What’s Next for California.”
August 30 – American Medical Association, “Mind the Gaps: Digital Health Issues and Opportunities.”
September 13-14 – Upper Midwest Telehealth Resource Center, “2022 UMTRC Annual Conference.”
September 26-28 – Northwest Regional Telehealth Resource Center, “Annual Conference: Innovation in Telehealth.”
September 29-30 – Northeast Telehealth Resource Center, “8th Annual Regional Conference: Exploring the Telehealth Universe.”
Previous Events, Podcasts, and Videos
Health Tech, “Keeping Equity at the Forefront in Telehealth.” Dr. Connie Shao, a general surgery resident at the University of Alabama at Birmingham, discusses her team’s study, which was presented at the 2022 American Telemedicine Association Conference. The qualitative study interviewed patients about their experiences, which found high patient satisfaction with video-based telemedicine. She also notes the use of telemedicine educators has been helpful, particularly for older patients.
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