May 22, 2023

Please find below the latest developments in federal and state virtual care policy as well as research, data, and polling on virtual care. 

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Congress

Sen. Manchin (D-WV): Reintroduction of the Protecting Rural Telehealth Access Act (5/17) - Sens. Manchin (D-WV), Ernst (R-IA), Shaheen (D-NH), and Moran (R-KS) and Rep. Pappas (D-NH) and five bipartisan cosponsors introduced the Protecting Rural Telehealth Access Act (H.R. 3440/S. 1636). The Alliance worked with the offices on this legislation in the last Congress and continues to support.  This bipartisan legislation would ensure rural and underserved community health care providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. Background information on the bill can be found here. Additional coverage can be found on WIBW. 

Rep. Matsui (D-CA): Reintroduction of the Telemental Health Care Access Act (5/16) - Reps. Matsui (D-CA) and Johnson (R-OH) reintroduced the Telemental Health Care Access Act (H.R. 3432), which would ensure coverage of mental and behavioral health services furnished through telehealth. Specifically, the bill removes the requirement that providers see Medicare beneficiaries in-person within six months of being treated virtually for mental and behavioral health concerns. Eliminating this arbitrary in-person requirement will ensure that patients can fully leverage telehealth to get the care they need from home. The Alliance for Connected Care endorsed this legislation. For additional coverage, see Rep. Johnson's press release, and Fierce Healthcare.

Inside Telehealth: GOP Lawmakers Press Department Of Labor (DOL) To Extend Standalone Telehealth (5/16) - The GOP leaders of the House Education & the Workforce Committee pressed DOL to immediately affirm that employers who provided telehealth as a stand-alone benefit prior to the end of the public health emergency (PHE) under a pandemic-era policy can continue offering that coverage for the duration of the plan year. In a letter, Committee Chair Foxx (R-NC), Health Subcommittee Chair Good (R-VA), and Rep. Walberg (R-MI) request DOL to publicly affirm employers can continue standalone telehealth for the duration of the plan year that began prior to May 11, and to answer their questions about a more permanent benefit by May 25. 

Administration

Inside Telehealth: After High Stakes February Meeting, MACs Will Not Make Local Coverage Determination For RPM, RTM Coverage (5/19) - Novitas Solutions and First Coast Service Operations (FCSO) sent an email telling select RPM and RTM advocates that the MACs will not be releasing a local coverage determination at this time after reviewing the extensive list of studies sent by advocates and hearing testimony at the Feb. 28 Contractor Advisory Committee meeting that sought to tease out the value of the services. The move also gives the Centers for Medicare and Medicaid Services (CMS) room to make a national coverage determination if it wants to take further action in the space. 

CMS: CMS Extends COVID-19 Telehealth Flexibilities for Hospital Outpatient Therapies (5/16) - CMS released an update to FAQs on the end of the COVID-19 PHE, which highlights that hospitals may continue to bill through calendar year 2023 for certain outpatient physical therapy, occupational therapy, speech language pathology services, Diabetes Self-Management Training, and Medical Nutrition Therapy provided by hospital staff to Medicare beneficiaries in their homes through telecommunication technology. For additional coverage, see American Hospital Association. 

Government Accountability Office (GAO): Why Health Care Is Harder to Access in Rural America (5/16) - In this blog post, the GAO reviews the difficulties in accessing health care in rural America. Many rural residents may turn to telehealth services—health care services delivered via phone or video—when care isn’t available locally. Telehealth can be an option to address limited provider availability in rural areas. However, the GAO found that, as of 2019, at least 17 percent of people living in rural areas lacked broadband internet access, compared to one percent of people in urban areas. Considering health care challenges faced by rural populations and the availability of financial incentives is important when developing programs for rural populations.

Telehealth Research, Reports and Surveys

Journal of the National Comprehensive Cancer Network: A Report on Patient Experience of Care (5/15) - In this retrospective study, researchers found that cancer patients who use telemedicine report better experiences than cancer patients treated in person. Researchers evaluated patients with solid tumors or hematologic malignancies who were treated at Moffitt Cancer Center in Tampa. Patient experience of care with telemedicine visits did not change over time, suggesting that implementing telemedicine was effective. For additional coverage, see Cancer Therapy Advisor. 

Journal of Medical Internet Research: Telemedicine Use by Age in Louisiana Medicaid During COVID-19 (5/15) - This claims-based longitudinal analysis found that Medicaid beneficiaries between the ages of 50 and 64 had higher telehealth claims during the COVID-19 pandemic compared to those aged 18 to 34. In April 2020, the 50 to 64 age group experienced an increase of 184.09 telehealth claims per 1,000 Medicaid beneficiaries. Researchers noted that this data shows that older patients in Louisiana had higher telehealth claim rates during the COVID-19 pandemic. Also, given that telehealth use remained high in December 2020, researchers also concluded that telehealth would likely serve as a channel for maintaining integral access to care. This data could serve as a tool for policymakers to determine telehealth laws and the policies that would most assist Medicaid beneficiaries. For additional coverage, see mHealth Intelligence. 

mHealth Intelligence: Telehealth Perceptions Vary Among Black Veterans with Chronic Pain (5/11) - Researchers from the Regenstrief Institute and the US Department of Veterans Affairs described telehealth perceptions among Black Veterans with chronic pain, which included both positive and negative experiences and views. Through qualitative interviews, researchers found that a few patients identified positive experiences with telehealth early in the pandemic. A major benefit associated with telehealth was the convenience of access it provided, as patients described their willingness to accept telehealth in return for lack of exposure to COVID-19. 

Telehealth News and Market Developments

Healthcare IT News: Addiction Recovery Provider Sees Success with AI-Enabled Telehealth Meds Monitoring (5/18) - In two years following 100 new-start opioid use disorder patients, an addiction medicine practice found 94 percent of patients remained in the medication-assisted treatment program – attrition rates had previously hovered around 54 percent. 

mHealth Intelligence: Continuous Care Program Aims to Streamline Data Collection (5/18) - Piedmont Healthcare, Telemetrix, and Remote Care Partners (RCP) announced the launch of a new continuous care program designed to improve the quality and relevance of patient information collected through remote care devices. The program combines RPMg software from Telemetrix with devices, care management, and coaching provided by RCP. The program will begin at two Piedmont medical facilities and then roll out across Piedmont Health System. For additional coverage, see Business Wire. 

Healthcare IT News: For Oak Orchard, Telehealth Relieves Shortage of Medical, Dental, and Mental Health (5/16) - Oak Orchard Health, a rural health system in New York, utilized virtual care during COVID-19, which provided patients access to care they otherwise could not receive without massive travel. As a rural federally qualified health center (FQHC), Oak Orchard typically faced many challenges – challenges inflamed by the pandemic. Typically, patients are unable to get reliable transportation. The solution Oak Orchard found was telehealth, which it continues to use today.

Business Wire: Included Health Introduces New, Virtual-to-Home, Care Model (5/16) - Included Health announced a partnership with DispatchHealth to create a virtual-to-in-home care model. This augmented offering will activate the home as a setting to treat everything from common to complex injuries, illnesses and disease, and offers great promise when it comes to reducing unnecessary emergency department visits and better managing interventions for patients with chronic conditions. For additional coverage, see mHealth Intelligence and Stat News. 

Health Leaders: Atrium Health Expands Virtual Care into a Housing Complex (5/15) - Atrium Health is locating a virtual care clinic within the Charlotte-based Peppertree Apartments complex, offering on-demand access to primary and specialty care services. The program is one of many being launched around the country by health systems seeking to address social drivers of health, or non-clinical factors that affect clinical outcomes. Within the past two years, Atrium Health has launched a health care program within a number of schools and YMCAs and expanded its remote patient monitoring platform through a partnership with Best Buy.

Healthcare IT News: For Ryan Health, Telehealth Seeds Planted During the Pandemic Have Flourished (5/15) - Ryan Health is a FQHC that has been providing comprehensive and affordable primary and specialty care to New York’s diverse and underserved communities since 1967. Prior to 2020 and the COVID-19 pandemic, there were federal and state policies in place that discouraged FQHCs like Ryan Health from adopting telehealth services due to payment restrictions. During the height of the pandemic, 80 percent of its visits were conducted through telehealth for both medical and behavioral health services. Ryan Health continues to advocate for telehealth payment parity for FQHCs so that telehealth services will be fully reimbursed. For additional coverage see McKnights Seniors Living. 

ABC Action News: The Drug Enforcement Administration (DEA) Delay Decision on Telehealth Regulations (5/15) - When COVID-19 hit, DEA used the PHE to greatly expand prescribing medication without seeing a patient in person. The DEA announced it would keep telehealth access for some medications but remove it for others, including buprenorphine, a major treatment for addiction. Kelly Dunn, executive director for clinical treatment at Oklahoma State University, predicts the DEA will likely try to allow easier access, in general, while regulating treatments with potential for abuse.

Health Leaders: Emory Healthcare Adds Digital Health Tools to New Behavioral Health Program (5/11) - Emory Healthcare launched a new collaborative care model (CoCM) as part of its Integrated Behavioral Health (IBH) program, aimed at integrating more behavioral health services in primary clinics throughout the health system. As part of that program, the health system is including a real-time digital health platform from NeuroFlow, which gives patients instant access to resources and tracks key health metrics. The collaboration will also serve as the foundation for a new suicide prevention program.

State Telehealth News

Center for Connected Health Policy: State Telehealth Laws and Reimbursement Policies Report, Spring 2023 (5/16) - The Center for Connected Health Policy (CCHP) released its Spring 2023 Summary Report of state telehealth laws and Medicaid program policies. The Summary Report provides highlights on certain aspects of telehealth policy and the changes that have taken place between now and the previous edition, Fall 2022. The information for this summary report covers updates in state telehealth policy made between January and March 2023.

Upcoming Events & Hearings

June 13 - mHealth Intelligence, "3rd Annual Remote Patient Monitoring Virtual Summit." 

June 15 - National Consortium of Telehealth Resource Center, "Telehealth Equity Among Medicare Beneficiaries." 

June 22 - National Council for Mental Wellbeing, "Rural Telehealth & M-Health for Immigrants & Migrants." 

September 27-30 - American Medical Association (AMA), "CPT® Editorial Panel & RUC Meetings." 

October 3 - mHealth Intelligence, "4th Annual Connected Health Virtual Summit." 

Previous Events, Videos, & Podcasts

Urology Times, "Dr. Finkelstein and Dr. Watts Describe Their Experience with Telemedicine." At the 2023 American Urological Association Summit, Lisa J. Finkelstein, DO, FACOS, and Kara L. Watts, MD, presented five key points for urologists to discuss with legislators regarding telemedicine. In this video, Finkelstein and Watts discuss their own use and experience with telemedicine.

NPR, "This Telehealth Program is a Lifeline for New Mexico's Pregnant Moms. Will It End?" Low Medicaid reimbursement rates and a lack of health workers are some of the biggest challenges to accessing obstetric care. The Federal Office of Rural Health Policy, which is part of the Health Resources and Services Administration (HRSA), launched the Rural Maternity and Obstetrics Management Strategies Program (RMOMS) to create telehealth networks. However, the funding is going to run out in September and moms are wondering how to continue accessing the maternity program. 

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