A bipartisan group of Senators reintroduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021. First introduced in 2016, the new bill would permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. It would also allow health centers and rural health clinics to provide telehealth services, and give the Secretary of Health and Human Services permanent authority to waive telehealth restrictions, among other provisions.
The federal government is investing more than $14 million in telehealth programs that integrate behavioral health services into pediatric primary care, dubbed Pediatric Mental Health Care Access (PMHCA) projects. Through PMHCA programs, states or health systems create pediatric mental healthcare teams that can include child and adolescent psychiatrists, licensed mental health professionals and care coordinators.
Recent analysis by Kaiser found that, of the 33.6 million Medicare beneficiaries with a usual source of care whose providers were offering telehealth, 45% had a telehealth appointment between summer and fall of 2020. Additionally, for those Medicare beneficiaries who had a telehealth visit, more than half (56%) used a telephone only.
The AMA authored a report in which they identify several environmental variables (including types of practice, payment arrangements, social determinants of health, clinical use case, and virtual care modality) and value streams (clinical outcomes, quality & safety, access to care, patient/family/caregiver experience, clinician experience, financial and operational impact, and health equity) that affect how a telehealth program generates value.
Senators Steve Daines (R-MT) and Catherine Cortez Masto (D-NV) introduced the Telehealth Expansion Act of 2021 (S 1704). The bill would increase access to telehealth by exempting telehealth visits from meeting deductible requirements in HDHPs. This exemption was a feature of the CARES Act, and the Telehealth Expansion Act of 2021 aims to make it permanent.
Representatives Jason Smith (R-MO) and Josh Gottheimer (D-NJ) introduced the "Permanency for Audio-Only Telehealth Act” (HR 3447). The bill would require Medicare to cover audio-only telehealth services after the COVID-19 public health emergency ends.
The Illinois legislature is considering a bill that would make COVID-19-related expansions to telehealth services permanent through state statute. The bill would prohibit geographic or facility restrictions on telehealth services, allow patients to be treated via telehealth in their home, protect patients from being charged any additional fees by insurance providers for accessing telehealth services, and ensure that patients are not required to prove any sort hardship or access barrier to receive telehealth services.
Upon the mid-pandemic resignation of Sanford’s CEO, Bill Gassen was elevated to the leadership role at a time when the organization was facing an unprecedented set of challenges. In an interview, Gassen discusses his experience and Sanford’s future plans, including a $300 million initiative to transform rural healthcare and expand their virtual strategy.
COPIC, a medical liability carrier, laid out five key points for providers to consider as telehealth becomes more mainstream. These include licensure, out-of-state practice, prescribing laws, liability, and documentation requirements.
A bill that recently arrived on the desk of Iowa Governor Kim Reynolds would create payment parity for telehealth services. If passed, private health carriers in Iowa would have to reimburse telehealth services at the same rate as theri in-person counterparts.
Wisconsin will fund a pilot program to expand internet availability in rural areas through use of SpaceX’s Starlink low Earth orbit satellites that can provide high-speed internet in rural areas where broadband is limited or not available.
Mental health professionals in northern Minnesota describe how telehealth has allowed more people to reach mental health services. The flexibility to be referred to other providers—both in and out of state—has helped people get connected to therapy during the pandemic.
The Marshfield Clinic Health system, which serves a rural area of northwestern Wisconsin, described their experience ramping up telehealth during the COVID-19 pandemic. Marshfield’s director of virtual care, Chris Meyer, also serves as a member of the Program Advisory Council of the Great Plains Telehealth Resource and Assistance Center (gpTRAC).
Jonathan Neufeld and Mary DeVany of gpTRAC will be presenting at the 2021 Minnesota Rural Health Conference. Their workshop, “Moving Telehealth from “Rapid” Implementation to Optimization”, is scheduled for Wednesday, June 23, from 9:15 - 11:15 am. Click here to access registration for the conference, which will take place from June 22 - 23, 2021.
Enrollment for the FCC’s EBB program will begin May 12, 2021. Eligible households will be able to enroll in the Program to receive a monthly discount off the cost of broadband service from an approved provider.
Included in a recent bill to increase health and human services funding by $59 in Iowa is legislation to expand telehealth. The policy component would create payment parity for tele-behavioral health, requiring private insurers to reimburse providers for behavioral mental health services whether delivered in-person or via telehealth.
The bill recently passed by the Illinois House would make COVID-19-induced telehealth expansion permanent in state legislation. The bill removes geographic or facility restrictions to telehealth and protects patients from being charged additional fees for accessing telehealth.
A bill calling for a pilot project on payment parity failed in North Dakota congress, with some legislators arguing requiring that in-person and virtual services charge the same is equivalent to “price setting.”
The end of the public health emergency may mean the end of regulatory flexibilities that telehealth care providers have relied on. To establish an effective telehealth program post-pandemic, Relatient, a Tennessee-based developer of patient engagement services, recommends five parts: let your patients know their options, enable a chat/secure messaging feature, adjust appointment reminder scripts to be more accessible, move registration online and to patient devices, and adopt a hybrid care mentality.
Several states have passed legislation that expand telemedicine, including South Dakota, where a bill was passed last month allowing patients to establish a telemedicine relationship with a physician remotely.
In a discussion with Mike Morgan, president of Updox, Morgan discussed the future of virtual care post-pandemic. Morgan noted that patients have come to like and expect some telehealth options going forward. Telehealth also allows providers to reach their patients on more platforms and to work more efficiently, thus optimizing their overall care-delivery strategy.
The Minnesota Senate unanimously passed the “Minnesota Telehealth Act,” while the House passed a health and human services omnibus package that included a similar bill. The Act would raise reimbursement rates for video or audio consultations between patients and providers. It would also expand the definition of telehealth to include additional medical services, such as mental health and substance abuse disorder treatment.
The American Board of Telehealth is offering an online, self-paced certificate program for providers interested in providing tele-behavioral health. The program comprises seven learning modules designed for a range of healthcare professionals, including psychiatrists, social workers, nurses, prevention specialists and more. The course is $395 for individuals and $195 for students, with discounts available for team training.
The University of Minnesota’s Mobile Resuscitation Consortium (MMRC) will be operating a mobile health van to treat heart attack victims through an ECMO (extracorporeal membrane oxygenation) machine that oxygenates a patient’s blood outside the body, allowing the heart and lungs to recover, then pumps that blood back into the body through cannula. Usually, patients would need to be kept stable while they are brought to a hospital to use the ECMO machine. The mobile van, likely launching summer 2021, will allow emergent care to get to patients sooner.
In its 2020 report, the Wisconsin Hospital Association reported significant provider shortages for nursing assistants, surgical techs, physician assistants, nurse practitioners, and registered nurse anesthetists, among others. The Association’s Vice President, Ann Zenk, said that the future will have them “exploring better and better and more efficient ways to utilize telemedicine.”