CCHP in the News

CCHP staff frequently contribute to articles on telehealth’s most pressing issues.

  • BREAKING: FCC repeals net neutrality rules, potentially affecting telemedicine

    Modern Healthcare

    The FCC voted 3-2 Thursday to repeal net neutrality rules, ending Obama-era regulations that prohibited Internet providers from blocking or slowing web content. Whereas all Internet traffic previously shared same "lane," it can now be split among different lanes with different speeds. Those differing speeds could hurt telemedicine since it requires a "pretty robust connection," said Mei Kwong, interim executive director and policy advisor for the Center for Connected Health Policy. "The last thing you want is for the interaction to suddenly freeze or the audio to go out or for the picture to be pixelated."  Though the FCC could make exceptions for healthcare so it's not subject to the same rules, Kwong and others said, that might still leave patients to fend for themselves.  "What do you do then for the individual who's at home and trying to get services at home?" Kwong asked.  These changes run counter to some recent VA efforts to expand telemedicine, she said. They also run counter to what the majority of Americans want, FCC commissioner Mignon Clyburn said Thursday. "Those very same broadband Internet service providers that the majority says you should trust to do right by you will put profits and shareholders returns above what is best for you," she said.  "When the current protections are abandoned, and the rules that have been officially in place since 2015 are repealed, we will have a Cheshire cat version of net neutrality," Clyburn said. "We will be in a world where regulatory substance fades to black and all that is left is a broadband provider's toothy grin."

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  • FCC's Net Neutrality Change May Have Big Implications for Telehealth

    California Health Care Foundation

    At the December 14, 2017, open commission meeting of the Federal Communications Commission (FCC), commissioners will vote on whether to repeal current net neutrality rules. Such action may have wide-reaching impacts on the use of telehealth. Community health clinics, such as federally qualified health centers (FQHCs) and rural health centers (RHCs), could see higher rates for connectivity that may reduce, eliminate, or discourage them from using telehealth to deliver health care services, especially in rural areas. Additionally, telehealth in the home could be severely curtailed as consumers may face higher prices for connectivity that would be sufficient for a telehealth interaction.  Removal of net neutrality rules could negatively impact several other pieces of telehealth policy that have gained traction in recent months at the federal level. The Department of Veterans Affairs has shown increasing interest in using telehealth regardless of where the provider and patient are located. This has been signaled by House passage of HR 2123, recent introduction in the Senate of the Veterans Community Care and Access Act of 2017, and proposed regulatory changes in the program.

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  • FCC’s Ajit Pai says net neutrality reform will help telehealth, but experts worry a tiered system complicates connectivity

    FierceHealthcare

    With the Federal Communications Commission poised to roll back Obama-era net neutrality regulation, FCC Chairman Ajit Pai has argued that the government’s light touch approach to high-speed internet will be a net benefit for telemedicine.  But industry experts worry that the agency’s reforms will be problematic for healthcare providers, telemedicine vendors, and patients, all of whom require robust connectivity to meet the demands of video consultations that could come at a higher cost.  In a speech last week at a conference about aging and technology, Pai defended the proposed changes, highlighting the potential benefits for telemedicine and remote monitoring, two technologies that are used with growing frequency to care for older Americans.  “One aspect of this proposal I think is worth highlighting here is the flexibility it would give for prioritizing services that could make meaningful differences in the delivery of healthcare,” he said. “By ending the outright ban on paid prioritization, we hope to make it easier for consumers to benefit from services that need prioritization—such as latency-sensitive telemedicine.”  

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  • OIG to review Medicaid telehealth payments amid an increase in claims

    FierceHealthcare

    The Department of Health and Human Services’ Office of the Inspector General (OIG) plans to audit Medicaid payments for telehealth services to gauge compliance with reimbursement requirements.  The OIG added the review to its work plan this week, noting that Medicaid programs are “seeing a significant increase” in claims for telehealth and telemonitoring services, a trend the watchdog agency expects will continue. The report is scheduled for 2019.  “We will determine whether selected States' Medicaid payments for services delivered using telecommunication systems were allowable in accord with Medicaid requirements,” the OIG update read.  It adds to another audit announced by the agency over the summer, which plans to review Medicare Part B telehealth payments. That review includes a specific focus on telehealth claims provided at distant sites that do not have corresponding claims to originating sites. In an update issued last month, the OIG pushed the date of that report to 2018.  

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  • Telehealth Report Offers Glimpse Into Variety and Complexity of State Telehealth Laws and Policies

    Lexology

    In the recently published fall update of the fifth annual edition of its telehealth report, the Center for Connected Health Policy, the federally designated National Telehealth Policy Resource Center, provides a current summary guide to telehealth-related laws, regulations, and policies for all 50 states and the District of Columbia, and tracks a number of telehealth trends. The report offers a revealing glimpse into the scope and complexity of state laws and policies governing telehealth. The authors conclude, however, that despite the fact that state laws and Medicaid policies “differ significantly” certain trends are coming into relief. Here are some highlights of the report: 48 states and the District of Columbia provide reimbursement for live video consults in their Medicaid fee-for service programs.

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  • 50 States of Telehealth: 5 Things to Know About State Reimbursement

    Beckers Hospital Review

    The Center for Connected Health Policy released its 50 state scan of telehealth reimbursement laws and Medicaid policies trends report. Here are five report insights:  1. Forty-eight states and Washington D.C. reimburse for some form of live video in Medicaid fee-for-service models. The two states that do not have written definitive reimbursement policies are Massachusetts and Rhode Island.

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  • 2 States Expanded Telehealth Reimbursement This Year, but Medicaid Policies are Still Inconsistent

    FierceHealthcare

    State Medicaid programs are making incremental progress when it comes to telehealth reimbursement, but there are still broad discrepancies among state policies, according to the Center for Connected Health Policy (CCHP). A biannual update to CCHP’s report on state telehealth laws and reimbursement policies indicates that two states—Maryland and Oklahoma—have implemented new reimbursement policies for store-and-forward telehealth since the organization’s last update in April. Oklahoma also added new payment policies for remote patient monitoring, but CCHP removed Hawaii and Kentucky from that list because there was no indication those states had implemented laws that included reimbursement for remote patient monitoring. As it stands, 48 states and Washington, D.C., provide reimbursement for telehealth that uses live video. Over the last two years, store-and-forward reimbursement has been steadily increasing, but currently just 15 states have enacted some kind of policy. Twenty-one states reimburse for remote patient monitoring, and just nine states pay for all three methods of telehealth.

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  • CCHP’s State Telehealth Report Shows Gradual Advances in Coverage

    mHealth Intelligence

    Nearly every state provides Medicaid reimbursement for video-based telehealth, according to the latest report from the Center for Connected Health Policy. In addition, 15 states cover store-and-forward or asynchronous services, and 21 states cover remote patient monitoring – while only nine states reimburse for all three platforms.  But the rules and regulations covering telehealth and telemedicine are as confusing as ever.  “No two states are alike in how telehealth is defined and regulated,” the CCHP points out in its State Telehealth Laws and Reimbursement Policies report, released today. “These differences are to be expected, given that each state defines its Medicaid policy parameters, but it also creates a confusing environment for telehealth participants to navigate, particularly when a health system or practitioner provides healthcare services in multiple states.”  The 262-page report – the group’s fifth annual study - paints an intriguing picture of the breadth and scope of telehealth and telemedicine in the US, and indicates that states are slowly moving to embrace digital health delivery – as evidence by the more than 200 telehealth-related pieces of legislation introduced in 44 states during the 2017 legislative season.  

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  • AVMA, AAVMC and AAVSB agree on Telehealth statement

    AVMA

    ​The American Veterinary Medical Association (AVMA), the Association of American Veterinary Medical Colleges (AAVMC) and the American Association of Veterinary State Boards (AAVSB) agree on a statement issued by the AVMA/AAVMC Joint Committee regarding telehealth and veterinary medicine.  “As the veterinary profession’s ‘umbrella’ organization, the AVMA understands that collaboration with veterinary regulatory/licensing boards and veterinary medical colleges is essential to help veterinarians take full advantage of new technologies in ways that best support the health and well-being of their patients,” said Dr. Mike Topper, president of the AVMA.  The statement reads:  Telehealth can provide valuable tools to augment the delivery and availability of high quality veterinary care. According to the Center for Connected Health Policy, “Telehealth encompasses a broad variety of technologies and tactics to deliver virtual medical, health, and education services. Telehealth is not a specific service, but a collection of means to enhance care and education delivery.” Veterinarians need to utilize emerging technologies to enhance accessibility and client communication, while promoting the responsible provision of high quality veterinary medical care. Both AVMA and AAVMC are committed to continue their collaboration with a wide variety of stakeholders to promote access to the convenience and benefits of telehealth, while providing information to the veterinary community about the development of applications and other technologies that help connect veterinarians with clients.

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  • Telehealth in the United States: A Year in Legislation

    Healthcare Analytics News

    As more states recognize the value of telehealth, the United States remains a patchwork of laws surrounding reimbursement for services. Some states have pushed toward comprehensive laws with wide definitions and guarantees of payment from both private and government insurers, while others still have yet to put anything on the books. Christine Calouro, of the Center for Connected Health Policy noted that, surprisingly, rural states are not always at the forefront. North Dakota, for example, passed its first private payer telehealth law in 2017—and South Dakota still does not have one.  Despite the disparities, Calouro said progress has been encouraging. “From all of the laws I’ve seen this year, none of them have really been restricting telehealth. They’ve all been expanding what’s allowable,” she told Healthcare Analytics News. In the future, she said, the goal should be not to look at telehealth as its own unique means of care, but rather an inherent tool for providers, a guaranteed element of the healthcare system.

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  • Telehealth Role in Value Based Care

    Health Management

    Mei Wa Kwong is Policy Advisor and Project Director at the Center for Connected Health Policy in the U.S.. As healthcare grapples with how telehealth can be utilised for better patient outcomes, Kwong answers HealthManagement.org’s question: In What Ways Can Telehealth Enhance Value Based Care?  Value-based care has been the subject of much discussion in US healthcare.  While the definition of what “value” means may vary from person to person, most do see value as encompassing the goals of the Triple Aim of quality care, better health outcomes and lower costs.  As the health care industry grapples with how to deliver value based care, telehealth is being increasingly looked towards as a potential tool to achieve this significant goal.  Telehealth is the use of technology to provide care from a distance when the patient and provider are in two different locations.  The unique features of telehealth lend itself well to a variety of ways of utilisation that would help achieve these goals. 

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  • Telehealth: The Future of Senior Living

    iAdvance Senior Care

    My father-in-law, who has early onset dementia, recently fell three times over a six-week period. During one of the episodes, he was not found until 24 hours later. He was admitted to the hospital for a week because of a pressure injury he developed from being on the ground for so long. He now wears a telehealth device that provides him with 24/7 monitoring and uses a medication reminder system that alerts caregivers if he does not take his medications. In many ways, advancements in technology, particularly those made to products and services in the consumer marketplace, have shifted what our seniors expect from the world around them. Accessibility, ease of use and general enhancements to quality of life are among the most obvious expectations seniors have. However, technology has offered senior living residents and their families another expectation—independence. Yet, some forms of technology, like remote monitoring devices that track a residents’ locations and activities, can be perceived as invasive.  

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  • Telehealth, Telemedicine Guidelines Gain Momentum in Florida

    mHealth Intelligence

    One of the last states to formally establish a telehealth policy has been busy this month.  The Florida Telehealth Advisory Council, created by the state’s Legislature in March 2016, has put together a draft report that, among other things, defines “telehealth,” establishes payment and coverage conditions for payers and encourages asynchronous (store and forward) telehealth and remote patient monitoring under the state’s Medicaid program.  That report, unveiled at the council’s Sept. 19 meeting, follows by five days a bill filed by State Sen. Aaron Bean that would turn most of those recommendations into state law.  “It is imperative that the State of Florida moves forward in setting the framework for telehealth so that patients can begin utilizing this new technology,” Bean said in a press release issued on Sept. 20, one day after the advisory council’s meeting. “This bill is a good starting point and includes recommendations from the Telehealth Task Force that was established during the 2016 Legislative Session to review this important issue.”  The advisory council, which is due to issue recommendations to the state by Oct. 31, drafted its report after a series of 10 public meetings, presentations from some 30 state and national telehealth experts (including the American Telemedicine Association and Center for Connected Health Policy) and a statewide survey conducted late last year that showed strong support for telehealth and telemedicine.  

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  • Study: States’ Private Payer Laws Are Harming Telehealth Growth

    mHealth Intelligence

    Two-thirds of the states in the US may have laws to promote telehealth and telemedicine coverage by private payers, but many of those laws are weakly written, giving payers too much discretion to set their own ground rules and turning providers away from those services.  That’s the conclusion of a study by the Center for Connected Health Policy, commissioned by the Reforming States Group and supported by the Milbank Memorial Fund. It paints the picture of a disjointed and vague set of rules governing private payers that are doing more to impede telehealth than promote it.  “This study makes clear there is broad misconception that because private payer laws are in place in many states around the country, telehealth is achieving its promise of parity of benefits and payment with in-person care,” the 34-page report, written by policy advisor Mei Wa Kwong and program associates Christine Y. Calouro and Laura M. Nassen, says. “The reality is that lack of clarity and clauses that impede the expansion of telehealth-delivered services weaken many of these laws.”  

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  • Mario Gutierrez: Improving Access for All, "Giving Voice to the Voiceless"

    California Health Care Foundation

    Debra Johnson vividly recalls the day she met her future husband, Mario Gutierrez. She was a young physician interviewing for a position in an Indian health clinic in Mendocino County, and he was working for the California Rural Indian Health Board. It was 1982.  "I was invited to go to a community meeting, and there were several different tribes represented. The clinic was in trouble," she said. "Mario was the only person I knew, and he signaled me to sit next to him. The meeting was getting more rancorous, more heated. People were calling people out. I sincerely thought it was going to come to blows in the parking lot. He turned to me and said, 'I think I've had enough.' And he went to the podium and said the tribes were going to have to come together and see this as a common good, and that the government was trying to keep them apart so they would remain as an underclass. After 30 minutes, he had them setting up a new board of directors and making a mission statement. I was just astounded. He could talk to a room full of people and make everyone feel important — and steer the ship in the direction it was meant to go. I thought, 'This is a man I really need to get to know.'"  

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