March 13, 2023

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. 

New Sign-On Letter Opportunities 

Alliance News

Harvard Law School: Alliance Executive Director Speaks on Interstate Telehealth Panel (3/9) - Krista Drobac, Executive Director of Alliance for Connected Care, joined an esteemed panel at the Harvard Law School's Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics' event on the federal policy landscape for interstate telehealth practices. Prior to the pandemic, most states required a physician to be licensed in the state in which the patient is located, and reinstating this standard—which was among those relaxed during the COVID-19 crisis—will be a major deterrent to interstate telehealth use. Patients will have to drive across state lines to have virtual consults with specialized experts, and providers will be dissuaded from developing truly national telehealth practices. More information on the Alliance's work on this issue can be found here.

Congress

Sen. Kennedy (R-LA): Kennedy Introduces Bills to Increase Louisianians' Access to Telehealth Services (3/9) - Sen. Kennedy (R-LA) introduced a package of bills to improve and broaden Louisianians’ access to telehealth services. The proposed legislation would make it easier for patients to connect with their doctors during an emergency or natural disaster. It would also end a regulation that limits access to telehealth services and expand access to virtual mental and behavioral health treatment.

• The Audio-Only Telehealth for Emergencies Act (S. 729) would provide for the waiver of certain telehealth requirements to permit reimbursement for audio-only telehealth services under the Medicare program during emergency declarations.
• The Enhance Access to Support Essential (EASE) Behavioral Health Services Act (S. 730) would provide for Medicare and Medicaid mental and behavioral health treatment through telehealth.
• The Telehealth Health Savings Account (HSA) Act (S. 731) would make permanent the permissible first-dollar coverage of telehealth services for purposes of health savings accounts.

Sen. Shaheen (D-NH): Shaheen, Capito Reintroduce Bipartisan Access to Prescription Digital Therapeutics Act (3/8) - Sens. Shaheen (D-NH) and Capito (R-WV) and Reps. Hern (R-OK) and Thompson (D-CA) reintroduced bipartisan, bicameral legislation to increase access to Prescription Digital Therapeutics (PDTs). The Access to Prescription Digital Therapeutics Act of 2023 (S. 723) would expand Medicare coverage to include PDTs, which are software-based disease treatments designed to directly treat disease. Prescription digital therapeutics can help treat a range of diseases, including substance use disorders and mental health challenges, but many who need this treatment currently lack access.

Rep. Manning (D-NC): Manning Leads 28 Bipartisan Members of Congress in Letter Urging the Department of Labor to Maintain Access to Telehealth Services (3/3) - Reps. Manning (D-NC), Fitzpatrick (R-PA), and Matsui (D-CA), led a bipartisan group of 28 Members of Congress in a letter urging the Department of Labor to issue guidance to support insurers and facilitate health plans that maintain access to telehealth appointments for mental health and substance use disorder, in compliance with federal parity law. Since the onset of the COVID-19 pandemic, the use of telehealth services for mental health and substance use disorder (MH/SUD) care has grown dramatically, with 41 percent of MH/SUD care delivered via telehealth by October 2020. Telehealth MH/SUD visits also made up the majority of all outpatient services delivered via telehealth in 2020 and 2021. 

Administration

White House: President's FY2024 Budget Request (3/9) - On March 9, President Biden released his Fiscal Year 2024 (FY24) budget request. The budget proposes $144.3 billion in discretionary and $1.7 trillion in mandatory budget authority for HHS for FY 2024. Specifically, the budget requests funding for the telehealth programs in the Health Resources & Services Administration (HRSA) programs, Agency for Healthcare Research and Quality (AHRQ) programs, and the Centers for Medicare and Medicaid Services (CMS). See the HHS Budget in Brief and Fact Sheet for telehealth specific-provisions.

Office of the National Coordinator for Health IT (ONC): Use of Telemedicine among Physicians and Development of Telemedicine Apps (3/9) - ONC published a blog on physicians’ use of telemedicine, which jumped from 15 percent in 2018 and 2019 to 87 percent in 2021. Through an analysis of National Electronic Health Record Survey (NEHRS) 2021 data and from in-house data collected from electronic health record (EHR) developers’ app galleries, ONC states it now has an opportunity to inform the public about physicians’ experiences with telemedicine during the pandemic. The blog also highlights the rapid growth of telehealth apps available to electronic health care users from January 2020 to June 2021. 

Telehealth Research, Reports and Surveys

Plastic and Reconstructive Surgery: Disparities in Telemedicine Literacy and Access in the United States (3/9) - According to a study published in Plastic and Reconstructive Surgery, demographic factors at the county level are associated with low telemedicine literacy. The researchers found that age, sex, race, employment status, income level, marital status, educational attainment, and urban or rural classification were significantly associated with telemedicine literacy. Counties in the lowest tertile of telemedicine literacy had significantly lower median annual income levels ($43,613 versus $60,418) and a lower proportion of the population with at least a bachelor’s degree (16.7 versus 26 percent). The study finds that patients who fall into specific socioeconomically disadvantaged groups are at the highest risk of being underserved by telehealth services. The findings may help in targeting at-risk communities for interventions to increase telemedicine literacy and access. For additional coverage, see Islander Media Group. 

PR Newswire: Telehealth Utilization Increased Nearly Four Percent Nationally in December 2022 Compared to Prior Month (3/7) - National telehealth utilization increased 3.8 percent in December 2022, from 5.3 percent of medical claim lines in November to 5.5 percent in December. The growth in telehealth utilization continued an increase begun in November. In December, telehealth utilization also increased in three US census regions—the South (7.1 percent), Midwest (5.0 percent) and Northeast (3.3 percent)—while remaining unchanged in the West. The data represent the privately insured population, including Medicare Advantage and excluding Medicare Fee-for-Service and Medicaid. For additional coverage, see mHealth Intelligence.

JAMA Network Open: Rates of Primary Care and Integrated Mental Health Telemedicine Visits Between Rural and Urban Veterans Affairs Beneficiaries Before and After the Onset of the COVID-19 Pandemic (3/7) - A study in JAMA Network Open tracking telemedicine visits pre- and post-pandemic across the VA reveals increasing inequities between rural and urban communities. Before the pandemic, 34 percent of rural VA health care systems used telemedicine for primary care services compared to a 30 percent use in urban areas. However, after the onset of the pandemic only 55 percent of rural systems used telehealth for primacy care, compared with 61 percent in urban areas. This study suggests that, despite a coordinated federal response, there is a rural-urban digital divide after the onset of the COVID-19 pandemic, particularly in mental health integration services. 

Telehealth News and Market Developments

Healthcare IT News: A Virtual Speech Therapy Trailblazer Offers a Deep Dive into This Telehealth Treatment (3/8) - Approximately 46 million Americans, roughly 14 percent of the population, experience some form of communication disorder. Speech language pathologists (SLPs) help address many types of speech and communication difficulties for people of all ages. Avivit Ben-Aharon, founder and clinical director at a virtual speech therapy company, spells out how this virtual care works and how it can achieve outcomes better than in-person care. 

Stat News: How Cross-State Licensure Reform Can Ease America's Mental Health Crisis (3/8) - Teletherapy has made mental health care more accessible than ever before, making care possible for people who otherwise would never have been able to get it. But the antiquated system of licensure in the United States is creating a huge barrier to realizing the potential for telehealth. Founder and CEO of Alma, Harry Ritter emphasizes the need for cross-state licensure reform now to address the needs of America’s growing mental health crisis and to ensure accessibility for everyone, regardless of their geographical location or identity.

Business Wire: Masimo and Temple Health Form Innovation Collaboration with Focus on Hospital Automation and Telehealth Initiatives (3/7) - With the goal of enhancing health care delivery through telehealth and remote patient monitoring (RPM), Masimo and Temple University Health System (Temple Health) are expanding their collaboration to include several new technologies and devices. Masimo is a global medical technology company that provides various monitoring technologies, such as measurement devices, sensors, and patient monitors, as well as automation and connectivity solutions. Made up of 979 beds, Temple Health is a $2.4 billion academic health system that aims to provide patients with access to quality care through Temple University Hospital and various specialty centers. The collaboration may now include several new tools, such as the Masimo W1 advanced health tracking watch, the Radius VSM tetherless, multimodal patient monitor, and other Masimo Hospital Automation solutions. For additional coverage, see mHealth Intelligence.

Kaiser Health News: Virtual or In Person: Which Kind of Doctor’s Visit Is Better, And When It Matters (3/6) - During the COVID-19 pandemic, patients and physicians turned to virtual visits by video or phone. Now, three years after the start of the pandemic, physicians and providers are trying to figure out when to opt for a telehealth visit versus seeing a doctor in person. Specifically, the article recommends in-person appointments if the physician decides it is medically necessary for the patient. 

The Wall Street Journal: WeightWatchers Moves Into the Ozempic Market With Telehealth Deal (3/6) - WeightWatchers announced the purchase of digital health company Sequence. This expands WeightWatchers's footprint into diabetes and obesity drugs including Ozempic and Wegovy. Sequence is a subscription service that offers telehealth visits with doctors who can prescribe the drugs. WeightWatchers, which has long promised to help customers lose weight through food-tracking and lifestyle changes, is moving to also offer customers a medical weight-loss approach. For additional coverage, see Forbes.

MedCity News: Remote Patient Monitoring (RPM) is Changing How I Provide Care, and My Patients Love It (3/6) - For patients with heart failure, type 2 diabetes, or hypertension, a quarterly office visit simply cannot provide the level of care needed to make the continuous and life-changing modifications we know are needed. A new kind of remote patient monitoring which combines digital technologies to monitor and capture medical information with clinical intervention is helping practices improve the health of patients and reduce unnecessary hospital visits. Cadence, a remote monitoring solution, employs a team of clinicians who can intervene with patients or their caregivers if needed.

State Telehealth News

mHealth Intelligence: How Telehealth Policy is Evolving at the State Level (3/9) - With the public health emergency ending on May 11, lawmakers are evaluating how telehealth policy needs to evolve to continue supporting the new normal in health care. At the state level, telehealth policies have evolved quickly, creating a patchwork of laws governing virtual care. But these telehealth policy changes were largely tied to states' public health emergency declarations. As these expired, many states only temporarily extended telehealth flexibilities, leaving the future of state telehealth policy unclear. Ben Steinhafel, director of policy and external affairs at the Center for Telehealth & e-Health Law (CTeL), spoke with mHealth Intelligence about state telehealth policy, how it has evolved over the past three years, and what it could look like in the year ahead.

Washington State Department of Health: Telehealth Sexual and Reproductive Health Care Services Now Available in Washington (3/8) - The Washington State Department of Health (DOH) has launched a webpage and tool to find telehealth sexual and reproductive health care services in Washington. The new DOH webpage and tool offers information about 37 clinics in the Washington State Sexual and Reproductive Health Network that provide telehealth appointments. Available telehealth services include birth control refills, pregnancy options counseling, emergency contraceptives, and screenings for sexually transmitted infections.

The Philadelphia Inquirer: Pennsylvania Legislators Say It's Time to Require Insurers to Pay for Virtual Health Care (3/6) - In Pennsylvania, private insurance companies don’t have to pay for patients’ virtual checkups with their own physician, or cover any health care services provided without an in-person visit. The state is one of just seven that doesn’t require insurers to cover telehealth. Now, after three years of widespread telemedicine use during the pandemic, and a new Democrat majority in the House, legislators are hopeful. 

“Telemedicine is too convenient and too effective to ignore as a tool at this point,” said State Rep. Michael Schlossberg, an Allentown Democrat who has advocated for telehealth for mental health care.

The Spokeman-Review: Washington Resumes Free Telehealth Appointments for COVID-19 (3/3) - The Washington State Department of Health has resumed its free telehealth program, allowing people with a positive COVID-19 test to get oral antivirals like Paxlovid. The program, which ran last year from July 28 through December, provided more than 4,200 prescriptions and saw around 6,300 patients from 400 ZIP codes throughout Washington state. 

“Restarting DOH’s telehealth program ensures that patients at high risk for severe disease have equitable access to lifesaving COVID-19 treatments,” said DOH’s chief science officer, Dr. Tao Sheng Kwan-Gett

Upcoming Events & Hearings 

March 14 - California Telehealth Resource Center, "Telemedicine Policy Update - The Past, Present, and Future of the Regulation of Telemedicine." 

March 14-15 – MedTech Intelligence, "ConnectedCare Summit East." 

March 15 – Mid-Atlantic Telehealth Resource Center, “2023 Summit.”

March 26-29 – HLTH, "ViVE 2023." 

April 12 - Arizona Telemedicine Program, "Navigating Telehealth Legislative and Policy Changes Beyond The Public Health Emergency." 

April 17-21 – Healthcare Information and Management Systems Society, “HIMSS23 Global Conference & Exhibition.”

June 13-14 – mHealth Intelligence, "3rd Annual Remote Patient Monitoring Virtual Summit: Overcoming Technology Access Hurdles to RPM." 

Previous Events, Videos, & Podcasts

Healthcare Finance, "Top Stories: Oppositions to the DEA Rule." It's been a big week for telehealth. What's new in the world of virtual care? We'll go over the latest in this week's Top Stories, including the AHA's support of bipartisan telehealth legislation, and results of a telemedicine-focused Rock Health study.

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