The President has signed the Coronavirus Aid, Relief, and Economic Security Act (H.R.748).  The language is a significant advancement for the telehealth community.  Here is a topline of the key telehealth provisions in the bill –

Sec. 3212. Telehealth network and telehealth resource centers grant programs.

  • This section would amend the current Telehealth Network and Telehealth Resource Centers grant program to specify that it will support evidence-based projects, to extend grant period funding to five years, rather than four, and assuring that 50 percent of funds shall be for projects in rural areas. Provides $29M for each of FY21-25.

 Sec. 3701. Exemption for telehealth services.

  • This section would allow a health plan or employer to provide pre-deductible coverage of telehealth and other remote care for individuals with health savings account (HSA) eligible high-deductible health plans (HDHP) for plan years beginning on or before December 31, 2021. This could be either discounted or fully covered care.

 Sec. 3703. Increasing Medicare telehealth flexibilities during emergency period.

  • This section would eliminate the requirement in Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 (Public Law 116-123) that limits Medicare telehealth expansion authority during the COVID-19 emergency to situations where the physician or other professional has treated the patient in the past three years.  The “qualified provider” requirement would instead be replaced with a Secretarial ability to waive all  requirements under 1834(m).

Sec. 3704. Enhancing Medicare telehealth services for Federally qualified health centers and rural health clinics during emergency period.

  • This section would allow, during the COVID-19 emergency, Federally Qualified Health Centers and Rural Health Clinics to furnish telehealth services to beneficiaries in their home or other setting. Medicare would reimburse for these services at a composite rate similar to payment provided for comparable telehealth services under the Medicare Physician Fee Schedule.

Sec. 3705. Temporary waiver of requirement for face-to-face visits between home dialysis patients and physicians.

  • This section would eliminate a requirement during the COVID-19 emergency that a nephrologist conduct some of the required periodic evaluations of a patient on home dialysis face-to-face., allowing these vulnerable beneficiaries to get more care in the safety of their home.

Sec. 3706. Use of telehealth to conduct face-to-face encounter prior to recertification of eligibility for hospice care during emergency period.

  • This section would allow hospice providers to conduct a face-to-face encounter required for recertification of eligibility via telehealth.

Sec. 3707. Encouraging use of telecommunications systems for home health services during emergency period.

  • This section provides the HHS Secretary the flexibility to consider ways to encourage the use of telecommunications systems and other communications or monitoring services, consistent with the care plan for the individual, as appropriate.

 

Appropriations:

Federal Communications Commission  

  • $200 million to remain available until expended, to prevent, prepare for, and respond to coronavirus, domestically or internationally, including to support efforts of health care providers to address coronavirus by providing telecommunications services, information services, and devices necessary to enable the provision of telehealth services during an emergency period

Dept of Agriculture        

  • $100 million for the costs of construction, improvement, or acquisition of facilities and equipment needed to provide broadband service in eligible rural areas
  • $25 million for the Distance Learning, Telemedicine, and Broadband Program (DLT) –The DLT grant program supports rural communities accessing telecommunications-enabled information, audio and video equipment, and related advanced technologies for students, teachers, and medical professionals

Indian Health Services

  • $1,032,000,000 to prevent, prepare for, and respond to coronavirus, domestically or internationally, including, but not limited to, funding for surveillance, testing capacity, community health representatives, public health support, telehealth, Purchased/Referred Care, and other health service activities necessary to meet the increase in need of services and to protect the safety of patients and staff
    • Up to $65,000,000 is for electronic health record stabilization and support

 Public Health and Social Services Emergency Fund          

  • $27,014,500,000, to remain available until September 30, 2024, to prevent, prepare for, and respond to coronavirus, domestically or internationally, including the development of necessary countermeasures and vaccines, prioritizing platform-based technologies with U.S.-based manufacturing capabilities, the purchase of vaccines, therapeutics, diagnostics, necessary medical supplies, as well as medical surge capacity, and related administrative activities, addressing blood supply chain, workforce modernization, telehealth access and infrastructure, initial advanced manufacturing, novel dispensing, enhancements to the U.S. Commissioned Corps, and other preparedness and response activities
    • $180,000,000 of the funds appropriated (under the Public Health and Social Services Emergency Fund) shall be transferred to ‘‘Health Resources and Services Administration—Rural Health’’ to remain available until September 30, 2022, to carry out telehealth and rural health activities under sections 330A and 330I of the PHS Act and sections 711 and 1820 of the Social Security Act to prevent, prepare for, and respond to coronavirus, domestically or internationally.

Health Resources & Services Administration (HRSA)

  • $275 million to remain available until September 30, 2022 for Ryan White programs, rural health programs, and telehealth programs.

Department of Veterans Affairs

  • $14.4 Billion to supports increased demand for healthcare services at VA facilities and through telehealth, including the purchase of medical equipment and supplies, testing kits, and personal protective equipment. Also enables VA to provide additional support for vulnerable veterans, including through programs to assist homeless or at-risk of becoming homeless veterans, as well as within VA-run nursing homes and community living centers.
    • The Secretary of HHS may enter into contracts with telecommunications providers in order to provider mental health services to isolated veterans during the emergency
    • Creates flexibility for telephone or telehealth renewals in the Veteran Directed Care program
    • Secretary of VA shall ensure telehealth capabilities are available to homeless veterans participating in HUD-VA programs