Alliance Submits Comments to Cures 2.0
The Alliance for Connected Care provided input into the draft Cures 2.0 legislation released in late June that will build upon the important legacy of the 21st Century Cures Act.
- A copy of the full Cures 2.0 discussion draft circulating now among lawmakers is available here.
- A section-by-section summary of the bill is available here.
The draft legislation includes several telehealth provisions including:
Sec. 402. Strategies to Increase Access to Telehealth under Medicaid and Children’s Health Insurance Program: collaborating with Reps. Blunt Rochester (D-DE) and Burgess (R-TX) to include the Telehealth Improvement for Kids’ Essential Services (TIKES) Act. This policy would provide guidance and strategies to states on effectively integrating telehealth into their Medicaid program and Children’s Health Insurance Program (CHIP), review the impact of telehealth on patient health and encourage better collaboration.
Sec. 403. Extending Medicare Telehealth Flexibilities: working with Reps Carter (R-GA) and Blunt Rochester (D-DE) to include the Telehealth Modernization Act. This policy would permanently remove Medicare’s geographic and originating site restrictions which require a patient to live in a rural area and be physically in a doctor’s office or clinic to use telehealth services. It would also allow the Secretary of HHS to permanently expand the types of health care providers that can offer telehealth services and the types of services that can be reimbursed under Medicare.
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Open in new tab At Mount Sinai, RPM provides more equal access to cancer care
At Mount Sinai, RPM provides more equal access to cancer care
With eight hospital campuses across the New York metropolitan area and a large regional ambulatory footprint, Mount Sinai is committed to improving health equity and access to care. Its expertise in population health, along with its service to socioeconomically, demographically and culturally varied populations, means Mount Sinai is uniquely positioned to take on the challenge of delivering high-quality care to underserved people.
An overview of the effect of telehealth on mortality: A systematic review of meta-analyses
An overview of the effect of telehealth on mortality: A systematic review of meta-analyses
Introduction
Methods
Results
Discussion
Federal Government Continues to Push False Narrative Regarding Telehealth Fraud
PUBLIC STATEMENT
May 26, 2021
Today, the Department of Justice (DOJ) issued a statement consistent with the federal government’s record of falsely creating the impression that telehealth is uniquely vulnerable to criminal behavior. No federal regulator or oversight body has yet issued a comprehensive study of telehealth claims during the pandemic, yet the agencies continue to send out charged statements with misleading headlines.
The reality is that the majority of instances of fraud highlighted by DOJ today in its “2021 National COVID-19 Health Care Fraud Takedown” have nothing to do with telehealth. The one case of alleged fraud billed as telehealth-related by the DOJ represents behavior that just as easily occurs in in-person settings. The HHS OIG has previously clarified that tele-fraud does not constitute telehealth fraud, and that their work to examine telehealth continues.
Over the first eight months of the pandemic, utilization of telehealth services in Medicare FFS sharply increased from about 325,000 services in mid-March to a peak of nearly 1.9 million services in late-April. As people began going back to in-person appointments, utilization of telehealth dropped. In early June there were 1.3 million billed telehealth services and the number of visits declined through mid-October.
These visits represent billions of Medicare dollars appropriately spent on telehealth visits. In today’s notice, DOJ indicates that it has uncovered $550,000 associated with false telehealth claims during the COVID-19 pandemic, which were associated with a broader scheme related to unnecessary genetic screenings. That represents an impossibly small fraction of a fraction of a percent of the total dollars appropriately spent on care for Medicare beneficiaries – providing treatments necessary during the pandemic, ensuring continued access to primary care, behavioral health, chronic disease management Imagine the secondary health catastrophe we would be facing right now if all Medicare beneficiaries had forgone chronic disease management services for an entire year.
To put these findings into further context, during the 2019 fiscal year, the Federal Government won or negotiated over $2.6 billion in judgments and settlements in health care fraud cases and proceedings. The level of telehealth fraud identified today does not seem to rise to the level of the “National Rapid Response Strike Force.”
Finally, contrary to the popular perception that there are many unscrupulous telehealth providers setting up shop to bilk Medicare, in a large survey conducted by the COVID-19 Taskforce, 83% of seniors saw their own doctor by telehealth. Eight percent saw a doctor in their provider’s practice, and 1.4% saw a provider recommended by their insurer. A mere 1% saw a doctor through an app or online service that they identified themselves. This hardly constitutes telehealth “mills” turning out false claims.
The Alliance for Connected Care continues to support efforts to root out health care fraud across all modalities, including telehealth and virtual care. To date, neither DOJ nor HHS OIG nor any other oversight body has identified a pattern of fraudulent behavior unique to telehealth as a modality of care.
We urge policymakers to read the fine print on these cases and develop interventions that are an appropriate level of response to the fraud challenges identified.
Alliance Statement for the Record to Senate Finance Hearing on COVID-19 Health Care Flexiblities
ALLIANCE FOR CONNECTED CARE STATEMENT FOR THE RECORD
“COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned”
The Alliance submitted a letter to the Senate Finance Committee on the “COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned.”
The Alliance will focus comments on 1) Research and evidence we have gathered thus far; 2) Recommendations for future telehealth expansion that Congress should consider – including steps to ensure equitable access; and 3) Recommendations for telehealth “guardrail” provisions that Congress should consider to prevent fraud, waste and abuse in the health care system.
While we prefer the implementation of permanent policies described in our recommendations below, the Alliance supports a two-year clean extension of telehealth flexibilities exercised during the COVID-19 pandemic, including 1834(m) Medicare telehealth waivers, a safe harbor for employer-subsidized telehealth for people with Health Savings Account eligible High Deductible Health Plans, and the flexibility for Critical Access Hospitals to continue to bill telehealth as they have during the pandemic. We want policymakers to feel comfortable that access to telehealth services in Medicare will not negatively impact health care quality, or the federal budget. Therefore, we recommend Congress wait to make permanent policy until more peer-reviewed research has been published, government studies – such as the study underway by AHRQ – have been completed, the Office of the Inspector General has examined the level of fraud in telehealth during the Public Health Emergency, and when we have observed what the use of telehealth during “normal times.”
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Alliance Support Letter for Delaware HB 21 & HB 141
The Alliance submitted a letter of support to Rep. Sherry Dorsey Walker, Chair of the Delaware House Sunset Committee (Policy Analysis & Government Accountability), for House Bill 21 and House Bill 141.
House Bill 21 would adopt the Advanced Practice Registered Nurse Compact. Under this compact, Advance Practice Registered Nurses (APRNs) licensed in a Compact member state may practice in another Compact member state, allowing APRNs to have one multistate license with the ability to practice in all Compact states without having to obtain additional licenses. Its companion bill, House Bill 141, would align the Delaware Board of Nursing statute with the APRN Compact to advance APRN practice through eliminating barriers such as collaborative practice agreements and granting full practice authority in conjunction with licensure to improve access to care for Delaware patients.
The APRN Compact would establish multistate compacts that have reciprocity and that do not require additional licensing, while simultaneously helping to improve patient access to quality health care. Additionally, removing the requirement for collaborative practice agreements for licensure purposes through House Bill 141 would allow APRNs to practice at the top of their licenses, allowing them to use all their education and training to care for patients.
Read the full letter here and below:
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Alliance Statement for the Record to House Ways & Means Committee Hearing on Telehealth
ALLIANCE FOR CONNECTED CARE STATEMENT FOR THE RECORD
“Charting the Path Forward for Telehealth”
The Alliance submitted a letter to the House Ways & Means Committee, Subcommittee on Health on the “Charting the Path Forward for Telehealth.”
The Alliance provided: 1) recommendations for telehealth expansions that Congress should consider – including steps to ensure equitable access, 2) comments about telehealth research and evidence, and 3) recommendations for telehealth “guardrail” provisions that Congress could consider, if it is believed they are necessary.
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Alliance Support Letter for Missouri SB 193
The Alliance submitted a letter of support to Senator Bob Onder, the Chair of the Missouri Senate Committee on Health and Pensions, for Senate Bill 193.
This legislation would remove geographic proximity requirements in collaborative practice arrangements between physicians and advanced practice registered nurses (APRNs) based in rural health clinics. The bill would also allow APRNs providing nursing services under a collaborative practice arrangement to provide such services outside the geographic proximity requirement if the collaborating physician and APRN utilize telehealth in the care of the patient and if the services are provided in a rural area located in a health professional shortage area.
The Alliance believes that eliminating geographic proximity requirements, especially for telehealth services, will significantly improve access to care for patients. Such barriers often delay care to patients, especially in rural underserved areas where there are often provider shortages and where APRNs are predominant in the state of Missouri.
Read the full letter here and below:
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Alliance Support Letter for Missouri SB 584
The Alliance submitted a letter of support to Senator Jeanie Riddle, the Chair of the Missouri Senate Committee on Professional Registration, for Senate Bill 584.
The bill would repeal the requirement under current law that supervised practice of an advanced practice registered nurse (APRN) under a collaborative practice arrangement by a collaborating physician occur for a one-month period of time. The bill would also repeal the requirement that an APRN can only provide telehealth services in rural areas of need in order to practice telehealth services outside the geographic proximity requirements of a collaborative practice agreement.
The Alliance believes that eliminating geographic proximity requirements, especially for telehealth services, will significantly improve access to care for patients. Such barriers often delay care to patients, especially in rural underserved areas where there are often provider shortages and where APRNs are predominant in the state of Missouri.
Read the full letter here and below:
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2021 Telehealth Summit for Health Systems
Thanks to those who were able to join the Alliance for Connected Care for the virtual Telehealth Summit for Health Systems on April 22-23, 2021.
The Alliance for Connected Care held its virtual Telehealth Summit for Health Systems on April 22-23, 2021. Attendees heard from federal policymakers from the White House and Congress on policy issues related to telehealth and virtual care, and participated in Breakout Sessions led by health system executives around the following topics: consumer engagement in virtual care, post-pandemic licensure portability, hardwiring virtual care transformation, and improving access across the digital and social divide. This recording includes opening remarks made by speakers on the first day of the Summit.
Slides from the opening session, entitled “A Pivotal Moment for Telehealth & RPM Policy: A Look Ahead to 2021,” can be found here.
Please note: Only Day 1 of the Summit from 11:30 – 1:30pm ET was open to the press. The Breakout Sessions were interactive working sessions and were considered off the record. As such, recordings and slides from the Breakout Sessions will not be made available.
Please contact Casey Osgood at casey.osgood@connectwithcare.org with any questions.
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Date: Thursday, April 22 – Friday, April 23, 2021
Time: 11:30am – 2:30pm EST