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January Regulatory Update – This Month in Telehealth

Federal and Medicare

Telemedicine Bill Could get House Vote this Week (Modern Healthcare)

The House this week is expected to vote on a bill that promotes telemedicine and was unanimously passed by the Senate last week.

Read more here

Read ECHO Act (S 2873) here

(Also see December’s “Gotcha of the Month” for more info on the ECHO Act)

American Heart Association Seeks Medicare Coverage of Telehealth (Health Data Management)

The American Heart Association is backing the use of telehealth services for heart disease and stroke, saying that medical evidence backs the clinical effectiveness of its use and saying the services should be covered by Medicare.

Read more here

21st Century Cures Act a Boon to Telehealth, Experts Say (Healthcare IT News)

In addition to big ticket items such as advancing precision medicine and interoperability, the new law contains a provision that targets telehealth services for Medicare beneficiaries.

Read more here

(To learn more about the 21st Century Cures Act read this month’s “Gotcha of the Month” below)

What’s Happening at the State Level?

Michigan

Top 5 Takeaways from New Michigan Telehealth Law

Michigan is ringing in 2017 with a new telehealth law. Governor Rick Snyder signed into law SB 0753 on December 21, 2016, imposing new telehealth practice standards, including restrictions on prescribing controlled substances via telemedicine

Read more here

Read SB 0753 here

Wisconsin

Wisconsin Issues New (and Improved!) Telemedicine Rules (National Law Review)

Following a public hearing last month, the Wisconsin Medical Examining Board approved new rules for the practice of telemedicine. The rules differ notably from its first set of rules proposed in 2015 and considered at a public hearing in January 2016.

Read more here

Regulatory Update Matrix

State Status Concerning Issue
Alaska Comments were due Oct 24th Dept. of Commerce, Community and Economic Development Telemedicine Business Registry
Arizona Final Board of Psychologists Telepractice and Supervision
Arkansas Comments were due December 30th Medicaid Coverage for telemedicine consults
Delaware Proposed- hearing Jan 3rd Board of Medicine Prescribing of opioids and the use of audio- only technology
District of Columbia Emergency Final FQHCs Telehealth
District of Columbia Proposed Department of Health Telemedicine practice standards for physicians
Louisiana Proposed– Comments were due Nov 21st Medical Board
Nebraska Final Medicaid State plan amendment removing mileage requirements and permitting RPM and asynchronous coverage
New York Draft Proposal Medicaid

***Information Gathered from ATA Monthly Update Webinar

Interstate Licensure Compact Updates…..

National Reciprocity
Department of Defense
TRICARE (S 2934 & 705(d) and HR 2725)
Department of veterans affairs (S2170 and HR 2516)
Medicare (S 1778 and HR 3081)
Expedited
Federation of State Medical Boards (FSMB) 18 states Alabama, Arizona, Colorado, Idaho, Illinois, Iowa, Kansas, Minnesota, Mississippi, Montana, Pennsylvania, Nevada, New Hampshire, South Dakota, Utah, West Virginia, Wisconsin and Wyoming
Mutual Recognition
National Council for State Boards of Nursing (Enhanced NLC and APRN) Arizona, Florida, Idaho, Missouri, New Hampshire, Oklahoma, South Dakota, Tennessee, Virginia, and Wyoming

 

Idaho and Wyoming joined the APRN Compact

Association for State and Provincial Psychology Boards (PSYPACT) Needs 7 states: Arizona

***Information Gathered from ATA Monthly Update Webinar

Monthly Legislative Update

Topic State Bill Number Status Issue
New Parity New Jersey S 291/ A1461 Proposed Coverage and reimbursement parity.
Parity, Medicaid, and Scope of Practice Licensure Changes Pennsylvania SB 1342/ HB 2267 Referred to Banking and Insurance Telemedicine
Scope of Practice/ Licensure Changes Michigan SB 753 Enrolled; Awaiting governor signature Telemedicine Standards

***Information Gathered from ATA Monthly Update Webinar

2016 Legislative Summary

Enacted or updated parity laws
Alaska, Arizona, Hawaii, Oklahoma, Rhode Island, Tennessee
Enacted legislation to change Medicaid
Connecticut, Hawaii, Iowa, Kentucky, Maryland, Missouri
Enacted legislation for changes to clinical practice standards of licensure laws
Alaska, Connecticut, Hawaii, Florida, Indiana, Louisiana, Michigan*, Missouri, New Hampshire, New Mexico, South Carolina, Tennessee, West Virginia, and Wyoming

***Information Gathered from ATA Monthly Update Webinar

In Other News…..

Welcome to the Future: Telemedicine and Value-Based Payment (AJMC)

Read more here

FSMB Survey Identifies Telemedicine as Most Important Regulatory Topic for State Medical Boards in 2016 (Newswise)

Read more here

HIT Think Why Medicare Needs to Increase Payments for Telehealth (HDM)

Read more here

Telemedicine for PTSD No Less Effective than In-person Therapy (WC Tribune)

Read more here

FYI…..

Recent Developments in Patient Engagement and Healthcare Cost Initiatives (JD Supra)

Read more here

The Growth of Telehealth: 20 Things to Know (Becker’s Hospital Review)

Read more here

“GOTCHA” of the Month…..

21st Century Cures Act

What is the 21st Century Cures Act?

The 21st Century Cures Act (HR 34), signed into law by President Obama this month, will allocate $6.3 billion for electronic health records, precision medicine, mental health and to fight opioid abuse. The legislation promises to have a significant impact by increasing access of Medicare beneficiaries to telehealth services.

Read the full text of HR 34 here

What are the key provisions of the Act?

  • HR 34 establishes a Health Information Technology (HIT) Advisory Committee. The committee’s target areas include HIT infrastructure, privacy and security, facilitation of secure access to protected health.
  • The Act Requires the Administrator of the Centers for Medicare and Medicaid Services (CMS), not later than 1 year after enactment, to provide to Congress information on the following:
  • The population of Medicare beneficiaries whose care may be improved most in a manner that meets or exceeds the existing limitations of telehealth services under section 1834(m)(4);
  • Activities by the Center for Medicare and Medicaid Innovation (CMMI) which examine the use of telehealth services in models, projects or initiatives funded by CMMI;
  • Types of high volume services which might be suitable for using telehealth; and
  • Barriers that prevent expansion of telehealth under 1834(m)(4).
  • It requires Medicare Payment Advisory Commission (MEDPAC) to provide to Congress, not later than March 15, 2018, information using quantitative and qualitative research methods on telehealth services for which payment can be made under Medicare fee-for-service parts A and B as well as services reimbursed by private insurers when delivered via telehealth. It also asks MEDPAC to identify services reimbursed by private insurers, but not reimbursed through Medicare, that should be considered for Medicare’s fee-for-service program.
  • The bill declares that it is the “sense of congress” that the list of eligible originating sites should be expanded when care is delivered in a safe, effective, high quality manner, it meets or exceeds the conditions of coverage and payment for in-person services and is clinically appropriate.
  • Requires the substance abuse and mental health services administration to collaborate with the Secretary of Defense and the Secretary of Veterans Affairs to improve the provision of mental and substance use disorder services, including through the provision of services using the telehealth capabilities.
  • Requires the Director of the Center for Mental Health Services to conduct services-related assessments, including evaluations of telemental health, among others.
  • Establishes a training demonstration grant program that would require its grantees to provide at least 1 training track that is a virtual training track that includes an in-person rotation at a teaching health center or in a community-based setting, followed by a virtual rotation in which the resident or fellow continues to support the care of patients at the teaching health center or in the community-based setting through the use of health information technology and, as appropriate, telehealth services. See bill for other required training tracks.  Applicants that demonstrate experience in HIT and telehealth (among other components) would be given priority.
  • Amends language concerning a grant that may be made by the Secretary to enhance services for students with mental and behavioral health problems, requiring funds to only be used for one or more of a specific list of activities outlined in HR 34, which includes (among others) providing mental and substance use disorders prevention and treatment services to students, including through the use of telehealth services.
  • Establishes the pediatric mental health care access grants which are intended to promote behavioral health integration in pediatric primary care by supporting the development and improvement of statewide or regional pediatric mental health care telehealth access programs.

Source: Center for Connected Health Policy

 

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