May 31, 2022

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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SIGN-ON CLOSING TODAY AT 2:00 PM ET

Urge Congress to Support Federal Funding for Telehealth Resource Centers 

Your organization is invited to join more than 60 organizations who have signed this letter urging Congress to support federal funding for Telehealth Resource Centers (TRCs) through Health Resources and Services Administration (HRSA) FY2023 appropriations. This increase in funding would provide a critical boost to the TRCs, which have experienced an 800 percent increase in demand for telehealth assistance during the COVID-19 pandemic and have been level-funded since 2006. This request is particularly relevant for anyone who plans to use the TRC’s State Telehealth Laws and Reimbursement Policies Report, which the Alliance recently featured.

The deadline to sign on is 2:00 pm ET on Tuesday, May 31

Congress 

Senate Finance Committee:  Wyden, Crapo, Cardin, Thune Release Telehealth Policies for Mental Health Care Initiative.  The Senate Finance Committee released a discussion draft for telehealth policies as a part of the committee’s ongoing work to improve mental health care across the nation, which has included a public call for comments and three hearings to help develop these initiatives. The discussion draft includes policies that would:

• Remove Medicare’s in-person visit requirement for tele-mental health services.
• Establish benefit transparency for mental health care services delivered via telehealth to inform Americans with Medicare how and when they can access telehealth.
• Preserve access to audio-only mental health coverage in Medicare when necessary and appropriate.
• Direct Medicare and Medicaid to promote and support provider use of telehealth.
• Incentivize states to use their CHIP programs to establish local solutions to serve behavioral health needs in schools, including through telehealth.

Introduction of the Connecting Rural Telehealth to the Future Act (H.R. 7876): by Reps. Adrian Smith (R-NE), Tom O’Halleran (D-AZ), and Kelly Armstrong (R-ND). The legislation would extend certain telehealth flexibilities for two years, giving patients and providers certainty while Congress works to make them permanent, including: 

• Extend all temporary telehealth provisions included in the FY22 omnibus through December 31, 2024;
• Permanently allow the use of audio-only technologies when providers are evaluating or managing patient health or providing behavioral health services;
• Restore Rural Health Clinic and Federally Qualified Health Clinic reimbursements for telehealth services to their normal reimbursement methods; and
• Extend allowance for Critical Access Hospitals (CAHs) to directly bill for telehealth services.

Introduction of the Kidney Health Connect Act (S.4307/H.R. 7878) by Sens. Mark Warner (D-Va.) and John Barrasso, M.D. (R-Wyo.) and Rep Brad Wenstrup (R-OH), and Reps. Dan Kildee (D-Mich.), John Joyce, M.D. (R-Pa.), Lisa Blunt Rochester (D-Del.) This legislation allows dialysis clinics to serve as originating sites for telehealth services and ensures patients are not responsible for any additional fees associated with their use.  Specifically, the bill would: 

• Allow dialysis clinics to serve as an originating site for Medicare telehealth services.
• Remove the 20 percent facility fee coinsurance obligation for patients accessing telehealth services in the clinic.

Administration

Inside Health Policy: OIG Says It Is Difficult To Compare In-Person, Telehealth Fraud - With telehealth stakeholders gearing up to lobby lawmakers for additional telehealth legislation after the end of the public health emergency and subsequent 151-day extension of COVID-19 pandemic telehealth waivers, distinctions between telehealth fraud and telefraud are again coming to the forefront as lobbyists await telehealth fraud studies from the HHS Office of Inspector General.

Krista Drobac, executive director of Alliance for Connected Care, said telefraud schemes have occurred long before pandemic telehealth flexibilities were put in place. “If the DME fraud was happening before 2020 it doesn't mean that if you keep the flexibilities in place that there's going to be more fraud -- because fraud isn't related to the flexibility,” Drobac said. “We cannot punish seniors and providers and prohibit them from having video visits for primary care and mental health and other things just because there's this telemarketing DME fraud that's been going on for decades. It has nothing to do with the authorities that we're fighting to make permanent.”

Telehealth Research, Reports and Surveys

Medscape: Telemedicine in Cancer Care: Not All Patients Can Access - Newly released study findings demonstrated that despite the increased use in telemedicine among patients across more than 20 cancer types, inequities in its usage remain. The largest disparity in telemedicine use was in people based on socioeconomic status —10.6% of patients living in the lowest socioeconomic status areas partook in telemedicine care compared with 23.6% of patients in areas with the highest socioeconomic status. Bloomberg reports that the study authors recommend making telehealth access permanent as a first step towards addressing disparities. 

Bioengineering: Telehealth and Burn Care: From Faxes to Augmented Reality - Telemedicine in burn care remains diverse, with varied outcomes in accuracy and efficiency. Newer technologies such as augmented reality have not been extensively studied or implemented but show promise in immersive, real-time triage. This study reviews the various modes of telemedicine in burn care and summarize relevant studies, including their contributions and limitations.

American Society of Hematology: Expanding telehealth possibilities: Performing virtual frailty exams in the home - A new study finds that frailty assessments are both feasible and safe when conducted virtually, increasing health care access for older adults with blood cancers. This is the first study to measure the effectiveness of a telehealth-based frailty assessment that incorporates both patient-reported and objective performance measures.

AARP: Interest in Telehealth Services is Holding Steady - Interest in using telehealth services is holding steady, with about one-third of U.S. adults age 50-plus reporting they are extremely or very interested in using telehealth services for themselves or for a loved one, a figure that is essentially unchanged since April 2020.

State Telehealth News and Activity

Mississippi Public Broadcasting: Mississippians now have permanent access to telehealth - Telemedicine is now a permanent fixture of healthcare in Mississippi, as Senate Bill 2738 has been signed into law. Because of insurance restrictions, emergency orders were issued during the height of the pandemic to allow telemedicine across Mississippi. Insurance Commissioner Mike Chaney says those orders ended months ago, but this law will allow telehealth to resume. The law prevents insurance providers from forcing patients to use an in-house telemedicine program, and some form of contact is necessary prior to an audio-only telehealth visit.

JDSupra: Alabama Enacts New Telemedicine Law - Alabama Governor Kay Ivey recently signed SB 272 into law, setting forth telemedicine practice standards and abolishing Alabama’s previous “special purpose license” that allowed physicians licensed in other states to practice across state lines into Alabama. The law is effective July 11, 2022.

Telehealth News and Market Developments

Healthcare Dive: Millions of people counting on Congress to protect telehealth access - Telehealth Access for America commended lawmakers for passing a five-month extension of telehealth protections after the end of the public health emergency as part of an omnibus spending package in March.  An April survey released by the Alliance for Connected Care found three in four respondents agreed patients should have the option to receive care via telehealth even after the pandemic. The survey also found 96% of healthcare practitioners believe virtual care expands patient healthcare access and 91% of healthcare practitioners agreed that they should be able to provide care virtually post-pandemic. Further, as the pandemic strains our healthcare workforce, the survey emphasized a high level of support for telehealth among healthcare workers, with 78% of healthcare practitioners agreeing that being able to provide telehealth services from practitioner-convenient locations would “significantly reduce the challenges of stress, burnout, or fatigue.”

mHealthIntelligence: CVS Health Unveils Telehealth Solution For Aetna, Caremark Members - The virtual care solution will provide health plan members with various services, including primary care and mental healthcare, in their chosen setting. Called CVS Health Virtual Primary Care, the digital care platform will provide healthcare consumers with an array of care services, including primary care, on-demand care, chronic condition management, and mental health services. Consumers will also be able to choose their healthcare setting from various retail, community-based, virtual, and at-home care options. The new solution will become effective for eligible Aetna members starting Jan. 1, 2023, and eligible CVS Caremark members during the second quarter of 2023. CVS Health Virtual Primary Care will also leverage an interoperable EHR to enable data-sharing between virtual and in-person settings.

Fierce Healthcare: Howard University, Teva Pharmaceuticals launch coalition to advocate for equity through digital health - A cross-industry coalition called the Digital Health for Equitable Health (DHEH) Alliance launched last week with the goal of reducing disparities through digital health.  For the coming year, “we’re not going to recreate the wheel,” Hill said of the coalition’s planned work. It will create its own initiatives to raise awareness about the organization and its mission, but ultimately it hopes to be a hub for resources on the intersection between digital health and health disparities.

Wall Street Journal: UnitedHealth Leans Into Telehealth to Reduce Costs, Meet Patient Needs - The Minnesota-based company owns the nation’s largest health-insurance company and markets a health plan to employers with lower premiums that require patients to seek a virtual visit before seeking treatment in person. The plan seeks to better coordinate care to get better results, more efficiently, Mr. Witty said.

Upcoming Events and Hearings –

June 1 – American Academy of Neurology & American Medical Association, “Clinical Case Study: Telehealth for Neurology.”

June 1-2 – Becker’s Healthcare, “The Shift to Digital Virtual Event – Telehealth, Home Health and Virtual Care.”

June 2 - AAMC’s Advancing Health Equity Through Telehealth Learning Series are a  series of webinars on the role of medical schools and teaching hospitals in promoting and advancing health equity through telehealth. 

June 3 – Center for Connected Health Policy, “Telehealth and School-Based Programs.”

June 10 – Center for Connected Health Policy, “State Licensure.”

June 17 – Center for Connected Health Policy, “Telehealth Private Payer Laws.”

June 24 – Center for Connected Health Policy, “Medicaid Telehealth Policy & Substance Use Disorder.” 

Please subscribe to this newsletter and send any news or events to casey.osgood@connectwithcare.org for inclusion.