Please find below updates on how the health care system is leveraging telehealth and remote patient monitoring - including research, data, and polling on its current use in response to COVID-19.
Washington Post Live: Digital Health with Xavier Becerra, John Brownstein, PhD, Tufia C. Haddad, MD, and Jack Resneck Jr., MD (6/24) – Washington Post hosted an event with HHS Secretary Becerra and a panelist of experts in medicine, technology and policy to discuss the future of digital health care and how to make it efficient and safe. During the event, HHS Secretary Becerra emphasized equity in technology and signaled the Administration’s ongoing support for telehealth in the long term. "We are absolutely supportive of efforts to give us the authority to be able to utilize telehealth in greater ways," said Becerra. A transcript and highlights can be viewed here.
Letter to House and Senate Leadership Urging Further Investment in Broadband and Digital Care Technologies: (6/28) – Reps. Spanberger (D-VA), Johnson (R-SD), Matsui (D-CA) and Curtis (R-UT) are announcing today a letter they led with 31 bipartisan members of Congress urging Congress to prioritize investments in broadband and digital care technologies, with a focus on directing resources to rural and medically underserved areas. The members of Congress point to the FCC’s COVID-19 Telehealth Program as a vital resource for health care providers, enhancing access and delivery of virtual services during the COVID-19 pandemic. Rep. Spanberger (D-VA) and Johnson (R-SD) introduced legislation last year to provide an additional $200 million for the FCC’s COVID-19 Telehealth Program. Congress eventually provided an additional $249 million in funding through the end-of-year Consolidated Appropriations Act. The Alliance for Connected Care has worked to support both the letter and legislative effort.
Rural and Frontier Telehealth Expansion Act: (6/23) – Sens. Rosen (D-NV), Sullivan (R-AK), Tester (D-MT), Capito (R-WV), Lujan (D-NM) and Murkowski (R-AK) introduced the Rural and Frontier Telehealth Expansion Act (S. 2197), which would increase the Federal medical assistance percentage for States that provide Medicaid coverage for telehealth services.
PREVENT DIABETES Act: (6/22) – Sen. Scott (R-SC), Warner (D-VA) and six bipartisan cosponsors introduced the Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-Based Strategies (PREVENT DIABETES) Act (S. 2173). The PREVENT DIABETES Act would increase access to the Medicare Diabetes Prevention Program (MDPP) Expanded Model by allowing CDC-recognized virtual suppliers to participate in the program. The Alliance and more than two dozen others endorse this legislation. In April, Reps. Rice (R-SC), DeGette (D-CO), Reed (R-NY) and Butterfield (D-NC) introduced identical legislation in the House (H.R. 2807). View the press release, one-pager, bill textlist of endorsing organizations.
Telemental Health Care Access Act: (6/22) – Reps. Matsui (D-CA) and Johnson (R-OH) introduced the Telemental Health Care Access Act (H.R. 4058), which would ensure coverage of mental and behavioral health services furnished through telehealth. On June 15, Sens. Cassidy (R-LA), Smith (D-MN), Cardin (D-MD), and Thune (R-SD) introduced identical legislation in the Senate (S. 2061). The Alliance for Connected Care has endorsed this bill because it repeals the in-person visit requirement that was placed on telemental health in the end-of-year 2020 legislative package. View the press release and bill text.
Proposal for Cures 2.0: (6/22) – Reps. DeGette (D-CO) and Upton (R-MI) unveiled their draft Cures 2.0 legislation, which outlines a set of policies to build on the 21st Century Cures Act, passed in 2016, and respond to needs that have emerged out of the COVID-19 pandemic. Among other things, the proposal seeks to remove barriers to telehealth access by making permanent some of the waivers exercised during the COVID-19 public health emergency, including the elimination of restrictions on originating and geographic sites. View the press release, bill text and section-by-section.
Specifically, the legislation includes sections:
Sec. 402. Strategies to Increase Access to Telehealth under Medicaid and Children’s Health Insurance Program: collaborating with Reps. Blunt Rochester (D-DE) and Burgess (R-TX) to include the Telehealth Improvement for Kids’ Essential Services (TIKES) Act. This policy would provide guidance and strategies to states on effectively integrating telehealth into their Medicaid program and Children’s Health Insurance Program (CHIP), review the impact of telehealth on patient health and encourage better collaboration.
Sec. 403. Extending Medicare Telehealth Flexibilities: working with Reps Carter (R-GA) and Blunt Rochester (D-DE) to include the Telehealth Modernization Act. This policy would permanently remove Medicare's geographic and originating site restrictions which require a patient to live in a rural area and be physically in a doctor's office or clinic to use telehealth services. It would also allow the Secretary of HHS to permanently expand the types of health care providers that can offer telehealth services and the types of services that can be reimbursed under Medicare
Enhance Access to Support Essential Behavioral Health Services (EASE) Act:
(6/22) – Reps. Bilirakis (R-FL) and Soto (D-FL) introduced the Enhance Access to Support Essential Behavioral Health Services (EASE) Act (H.R. 4036), which would provide for Medicare and Medicaid mental and behavioral health treatment through telehealth. Sen. Kennedy (R-LA) introduced companion legislation in the Senate (S. 2112).
Advancing Telehealth Beyond COVID-19 Act of 2021: (6/22) – Reps. Cheney (R-WY) and Dingell (D-MI) introduced the Advancing Telehealth Beyond COVID-19 Act of 2021 (H.R. 4040), which would extend telehealth flexibilities under the Medicare program. Providers would be allowed to deliver telehealth services to patients in their homes regardless of what part of the country they live in, and would permanently allow Medicare to pay for doctor’s visits via audio-only phone calls, rather than requiring a video component for every call. The bill would also make permanent the telehealth coverage at Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC). Finally, the bill removes restrictions that limit health care providers’ ability to provide access to smart devices and innovative digital technology to their patients. View the press release and bill text.
State Telehealth Activity
KTOO: Alaska Patients Have Reduced Access to Out-of-State Telehealth Appointments as Emergency Declarations End (6/26) – Pandemic-era licensing waivers expired in Alaska with the recent governor’s order, making it harder for Alaska patients to get telehealth appointments with their doctors who reside outside of the state. Over the pandemic, Alaska patients had thousands of telehealth appointments with out-of-state providers. Jared Kosin, head of the Alaska State Hospital and Nursing Home Association, said that over a year of pandemic telehealth waivers is enough time to know that this works for patients.
Delaware Public Media: Bill Expanding Access to Telehealth in Delaware Becomes Law (6/23) – Delaware Governor John Carney signed the Telehealth Access Preservation and Modernization Act of 2021, which makes permanent some of the temporary provisions for telehealth enacted during the pandemic. This bill extends measures allowing patients to access telehealth services even if they have never met with their provider in-person before. It also allows for audio-only telehealth to help those without broadband access or smartphone devices.
Healthcare IT News: Texas Passes Law Authorizing Teledentistry (6/21) – Texas Governor Greg Abbott signed a bill into law that would formally authorize dentistry service via telehealth. This bill will take effect September 1 and will prevent the State Board of Dental Examiners from banning teledentistry and bring teledentristy in line with other telemedicine practices.
The Link News: Assembly Passes Bill to Improve Accessibility of Telehealth and Telemedicine Services (June 2021) – The New Jersey Assembly passed a bill to provide expanded coverage for telemedicine and telehealth services in the state. The bill would require carriers offering health benefit plans in New Jersey, the State Medicaid and NJ FamilyCare programs, the State Health Benefits Program and the School Employees’ Health Benefits Program to reimburse providers for certain physical and behavioral health care services delivered via telehealth at a reimbursement rate that is at parity with in-person care.
Office of New York State Comptroller DiNapoli: Growth in Use of Telehealth Services Among Medicaid and Child Health Plus Beneficiaries in New York (6/24) – While telehealth usage in New York and nationally has declined since the pandemic peak, it remains well above pre-pandemic levels, though still only a small share of overall utilization. Demographic data show that adults from 25 through 64 years of age accounted for 59 percent of all telehealth services for Medicaid and CHP beneficiaries in New York from March through November 2020. The CMS data about the types of telehealth services used by the State’s beneficiaries during the pandemic period show 70 percent were categorized broadly as office or outpatient evaluation and management (E/M) and another 26 percent were behavioral health E/M.
Telehealth Research, Reports and Surveys
American Diabetes Association: Immediate and Sustained Trends in Glycemic Control during Remote Patient Monitoring in People with Type 2 Diabetes (6/25) – A study investigated whether people with type 2 diabetes (PWT2D) demonstrate improved glycemia after enrolling in remote patient monitoring (RPM) pilot programs that incorporated remote data syncing and coaching. Glycemic improvements were seen within 3 months of program participation and were sustained with continued engagement. The findings indicate that RPM programs that incorporate remote data sharing and coaching can make a substantial impact on glycemic control for people with type 2 diabetes.
The Commonwealth Fund: States’ Actions to Expand Telemedicine Access During COVID-19 and Future Policy Considerations (6/23) – During the pandemic, 22 states changed laws or policies to promote access to telemedicine. States focused on three key areas: requiring coverage of audio-only services, waiving cost-sharing or requiring cost-sharing no higher than identical in-person services, and requiring reimbursement parity between telemedicine and in-person services. Of the 22 states that expanded access to telemedicine during the pandemic, most pursued making changes via administrative actions, according to the report. In 2021, at least 30 states have weighed legislation to revise telemedicine coverage standards.
Telehealth News and Market Developments
mHealth Intelligence: SF-Based FQHC Adds Telehealth, Remote Patient Monitoring to PACE Services (6/25) – North East Medical Services, which serves more than 65,000 people through 12 clinics in San Francisco, Daly City and San Jose, is partnering with LucidAct Health, a Silicon Valley-based virtual care company, to enhance its Program of All-inclusive Care for the Elderly (PACE) platform. The partnership will add RPM and telehealth services to the program, allowing the FQHC’s care providers to monitor patients at home and connect with them via virtual channels when needed.
Healthcare Dive: Biden admin 'absolutely supportive' of telehealth once crisis ebbs, Becerra says (6/24) – As previously highlighted, HHS Secretary Becerra made several mentions of expanding telehealth permanently at an event hosted by The Washington Post. House and Senate combined, Congress currently has more than 40 bills that include significant telehealth or remote monitoring provisions before them, Healthcare Dive reports – citing the Alliance for Connected Care’s legislation tracker.