Insider NJ: Sherrill to Biden – Protect Access to Telehealth for New Jerseyans Now
(4/28) – Congresswoman Mikie Sherrill (D-NJ) led a bipartisan letter to the Biden Administration, calling for the Administration to ensure Americans do not lose access to telehealth at the end of the COVID-19 public health emergency. The letter calls on the Administration to protect coverage of flexibilities expected to expire on May 11, such as those allowing for prescribing of controlled substances via telehealth, direct supervision of trainees via telehealth in an academic medical setting, and telehealth as an excepted benefits for individuals not eligible for employer-sponsored health insurance.
Inside TeleHealth: Lawmakers, Stakeholders Divided on Stand-Alone Telehealth Benefits (4/27) – The House Education and the Workforce Committee, Subcommittee on Health, Education, Labor and Pensions held a hearing
on health care costs on April 26, 2023. Among the topics discussed was telehealth, specifically the bipartisan Telehealth Benefit Expansion for Workers Act (H.R. 824) which sits in the Committee’s jurisdiction. The bill would permanently allow employers to offer telehealth as a standalone benefit for employees who are not otherwise eligible for employer-sponsored health insurance, such as seasonal or part-time workers. This flexibility will expire with the end of the public health emergency if no action is taken by Congress, however lawmakers are split on this flexibility. Rep. Walberg (R-MI), one of the bill’s co-sponsors, expressed support for this legislation during the hearing, emphasizing how telehealth was a lifeline for millions during the pandemic.
Expanding Care in the Home Act(4/25) - Reps. Smith (R-NE) and Dingell (D-MI) introduced the Expanding Care in the Home Act (H.R. 2853), which would expand access to clinical care in the home. The bill aims to move more care from the hospital and other health care facilities to the home, and marks a rare bipartisan collaboration on a potential solution to Medicare’s financing problem. The bill has drawn support from tech companies, insurers, venture capitalists, providers and telehealth advocates. For additional coverage, see Politico Pro.
Centers for Medicare & Medicaid Services (CMS): The Biden-Harris Administration Proposes New Standards to Help Ensure Access to Quality Health Care In Medicaid and CHIP (4/27) – CMS issued two new proposed rules, Ensuring Access to Medicaid Services and Managed Care Access, Finance, and Quality, which together would further strengthen access to and quality of care across Medicaid and CHIP. Notably, the Medicaid Managed Care proposed rule includes a proposal that would establish national maximum standards for certain appointment wait times and stronger state monitoring and reporting requirements related to access and network adequacy. This would apply to routine primary care, obstetric/gynecological services, outpatient mental health and substance use disorder services, and unspecified state-selected services. CMS cites telehealth as a tool that could help Medicaid managed care plans to meet these requirements. CMS advises states in the proposed rule to review encounter data to gauge beneficiaries’ telehealth use over time as well as the availability of telehealth appointments by providers, and account for that information when developing appointment wait time standards.
Office of Management and Budget (OMB): Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications (4/26) - The OMB publicly disclosed that it has received draft text of a rule from the Drug Enforcement Administration (DEA) to temporarily extend COVID-19 Telemedicine Flexibilities for Prescription of Controlled Substances. While there is limited information posted, based on the title, it seems to be a short-term extension of DEA flexibility while the agency completes work on the many other edits needed to make the long-term rulemaking workable.
Department of Health and Human Services (HHS) Office of Inspector General (OIG): Toolkit Analyzing Telehealth Claims to Assess Program Integrity Risks(4/24) - HHS OIG released a resource aimed at helping insurers, Medicaid fraud control units, and federal health agencies identify waste, fraud, and abuse risks in telehealth. The document details how to analyze virtual care claims and flags conduct that could indicate integrity risks. The toolkit includes detailed descriptions of seven data analysis measures that can be applied to the user's own data. Users can also modify the measures to meet their individual needs, such as identifying providers at varying levels of risk.
Telehealth Research, Reports and Surveys
Journal of Medical Regulation: Increasing Access to a Diverse Mental Health Workforce Through Emergency Reciprocity Licensure (4/6) - New Jersey's COVID-19 Temporary Emergency Reciprocity Licensure Program provided temporary licenses to more than 31,000 out-of-state health care practitioners, over a quarter of whom were mental health providers. As the need for mental health care accelerated during the pandemic, especially among health disparity populations, expanding mental health provider pools may be a critical tool to increase access to care. In January 2021, researchers at Rutgers surveyed New Jersey's temporary licensees, analyzing over 4,500 mental health provider responses to examine the impact of the temporary licensure program on access to mental health care overall and on enhancing a diverse mental health workforce. Over 3,700 respondents used their temporary license to provide mental health care to New Jersey patients. Findings suggest that temporary out-of-state mental health providers helped enhance mental health care continuity and access.
Telehealth News and Market Developments
Inside TeleHealth: RUC Meets to Determine Payment for New Telehealth Codes, Addresses Payment Parity (4/28) – The American Medical Association’s payment valuation committee will meet April 26-29 to discuss the 17 newly accepted telehealth evaluation and management CPT codes that will determine the future of telehealth payment and broach the long-standing payment parity debate. The RUC will meet to assess the payment rate of CPT codes and will make payment recommendations to CMS for the CY2024 Physician Fee Schedule proposed rule.
Benefits Pro: Bridging America’s care gap with virtual solutions (4/27) – With the rapid adoption of virtual care, benefits consultants and employers are able to provide a primary care solution to all group sizes, and help clients ensure their employees are receiving care when they need it. Virtual care provides many benefits, including enhanced access to care, cost savings, and convenience. The article quotes a study by the Progressive Policy Institute and Americans for Prosperity (shared on the Alliance for Connected Care website) that shows using virtual care helped decrease patients’ health care costs by 61 percent, for example. The article emphasizes that it is critical for benefit strategies to have virtual care solutions built in for quality health outcomes and meaningful cost savings.
Business Wire: Walmart Health Expands into Oklahoma with Four New Health Centers in 2024 (4/26) – Alliance board member Walmart announced it is opening four new Walmart Health centers in Oklahoma. These facilities will be located beside Walmart Supercenters and will feature Walmart Health’s full suite of health services, including telehealth, primary care, labs, behavioral health services, and other health care services.
mHealth Intelligence: UAB Gets $3.3M to Test Telehealth Cardio Program (4/25) - The University of Alabama at Birmingham (UAB) received a $3.3 million grant from the National Institutes of Health (NIH) to test a telehealth cardio program. Researchers intend to operate a 24-week program containing a remote training system to determine the abilities of the program in handling cardiometabolic risk factors through videoconferencing and virtual sign monitoring. Researchers also noted that this study is an extension of a previous effort, however, its concentration shifted toward cardio.
Healthcare IT News: Parkview Health Gets 70 Percent of Patients onto Epic Portal, Home of its Telehealth Programs (4/25) - Parkview Health System has incorporated its telemedicine programs into a larger digital health strategy aimed at meeting patients wherever they have a need for care. The Indiana health system has achieved massive success with its patient engagement and telemedicine initiatives. Maximilian Maile, senior vice president of digital health at Parkview Health System, shares recommendations for other organizations who have to navigate digital health or telemedicine initiatives.
MedCity News: Hint Health Partners With Eden Health To Expand Direct Primary Care Network (4/24) - Hint Health, a digital company focused on direct primary care (DPC), announced it is teaming up with Eden Health, a virtual and in-person primary care provider. Through the partnership, employees of Hint Connect’s employer customers will be able to choose whether they want to receive care from a local DPC provider in their area (either in-person or virtually) or a virtual provider through Eden Health. The choice comes down to each individual employee. Eden Health provides primary care, urgent care, chronic disease management and care coordination services. The collaboration will especially benefit employees who live in remote areas without a DPC provider.
Becker's Hospital Review: Cleveland Clinic Launches Neurological Telehealth Program (4/24) - Cleveland Clinic is launching a neurological telehealth program through a partnership with medtech company Genentech. The partnership aims to facilitate health care delivery for lower socioeconomic status patients and patients living in rural areas. Previously, Cleveland Clinic and Genentech worked on a 2022 research project that studied the utilization of telehealth among 200,000 patients living with a neurological condition. Neurological telehealth care saw an uptick during the COVID-19 pandemic.
State Telehealth News
American Counseling Association: Montana Becomes Twenty-Third State to Sign Interstate Counseling Compact Into Law (4/26) – Montana Governor Greg Gianforte signed the state’s Counseling Compact legislation into law this week, making Montana the 23rd state to ratify the compact. The Counseling Compact allows professional counselors licensed and residing in a compact member state to practice in other compact member states without the need for multiple licenses.
Academy of Nutrition and Dietetics: Potential Interstate Licensure Compact (4/25) - Under current licensing laws, a registered dietitian nutritionist who provides medical nutrition therapy in multiple states, either in person or through telehealth, must become licensed according to each state’s requirements; this can be time-consuming and costly. A potential solution to facilitate cost-effective interstate practice for licensed RDNs is a licensure compact. The Academy of Nutrition and Dietetics was selected through a competitive grant process for Department of Defense funding to work with the Council of State Governments’ National Center for Interstate Compacts on an interstate RDN licensure compact.
CT Examiner: Telehealth Provisions on Hold as Legislators Debate Reimbursement, Out-of-State Doctors (4/19) – Connecticut lawmakers are stepping back from passing a proposal to extend pandemic-era insurance reimbursements for telehealth and expand the pool of health care providers who can offer telehealth services across the state. In 2021, the state legislature passed a law requiring that doctors, physical therapists, mental health providers, paramedics, athletic trainers, and other health care providers in Connecticut be reimbursed for telehealth visits at the same rate as seeing patients in person. The equal reimbursement provision for telehealth is set to expire on June 30, 2024. A new proposal that was approved in the Health and Human Services Committee would extend that reimbursement requirement. The bill would also allow out-of-state medical professionals to see patients in the state remotely. The bill will likely be modified before getting voted on by the full legislature.
Please join us for the 2023 Telemedicine Symposium, a collaboration between Yale New Haven Hospital, Johns Hopkins Medicine and University of Maryland Medical System. Chris Adamec, Vice President of the Alliance for Connected Care, will be speaking at this "Telehealth Symposium."
Urology Times, "Dr. Watts on the Originating Site in Telemedicine." At the 2023 American Urological Association Summit, Lisa Finkelstein, DO, and Kara L. Watts, MD, presented five key points for urologists to discuss with legislators regarding telemedicine. The first was elimination of the originating site requirement, which Watts discusses in this video. “Allowing the waiver to continue indefinitely would be a tremendous win for telehealth for both sides, the patients and the health care providers,” says Kara L. Watts, MD.