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Telehealth Experiences Big Boom In Era Of Social Distancing

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Rapidly changing the landscape of healthcare, telehealth has gained widespread popularity in the past few years, giving millions of people around the world the ability to meet with their medical professionals from home via their computer, tablet or smartphone. And never has it been more necessary than it is now.

Telemedicine isn’t anything new. In fact, The National Center for Biotechnology Information reports that the initial form of it was first used in the 1950s and ’60s. But chances are, like many others, 2020 may have been your first hands-on experience with it.

According to Medical Economics, a recent study by Doctor.com showed that telehealth appointments were up 33% at the beginning of 2020 from 2019. Obviously, that percentage will have skyrocketed after last year’s pandemic statistics are folded in. As the leader of a global online hearing care company, I can attest to the fact that one of the areas that had to expand quickly to offer a telehealth solution was hearing care. Many medical professionals and organizations that hadn’t already made the shift to offering virtual medicine prior to Covid-19 found themselves scrambling in 2020 to figure out how to quickly and safely expand their service model.

Believing that teleaudiology was part of the future of hearing care, we’ve been experimenting with our virtual experience for the past five years. We found the hearing care environment in Asia was a great place to focus our early energy, as there was a shortage of audiologists and it was difficult for customers to travel to the limited locations. At the same time, in other markets, we discovered that customers weren’t comfortable receiving care or being seen on video. But in 2020, that changed, even for customers aged 60-plus. Perhaps the experience of using tools like FaceTime and Zoom to connect with their grandkids helped pave the way and break down those barriers.

Telehealth allows licensed providers to conduct certain tests virtually so that the patient never has to leave their home. Not only does this ensure the safety and health of the patient — notably during the age of social distancing — it also allows people all over the world who don’t have transportation or easy access to certain types of care to obtain the same level of care at home. While this was a big issue long before this pandemic, Covid-19 just happened to shine a brighter light on the issue.

Facing Telehealth Challenges Head-On

While I’m thrilled that providers can now use telehealth to help bridge the gap for those who need it most, there are still some challenges when it comes to serving a global community. We identified the following as two major hurdles early on. Other telehealth providers will likely face the same and need to implement solutions to ensure those who need care are never without access.

• Internet connectivity is one of the largest challenges telehealth providers around the world face today. Unfortunately, from a patient perspective, not everyone has access to high-speed internet and Wi-Fi to be able to connect from home. One way to tackle this across the globe is to send tablets that connect directly to cell service through the local wireless network, rather than operating solely through WiFi. This has been our approach, and our IT department is also able to remote into the tablet while the customer is using it to help them identify the best connection.

• The reality of telehealth is that some medical concerns do require in-person visits. There is an obvious loss of physicality with remote solutions where the doctor can’t touch or feel, or as in our industry, conduct certain aspects of a hearing test in person. For example, a comprehensive hearing exam requires a specialist to look inside your ear canal. Therefore, telehealth companies must create solutions that allow partner providers to conduct certain tests through tablets and digital tools that can be sent to customers in advance of their appointment.

We’ve discovered that by mirroring in-person visits as much as possible, telemedicine customers actually have more success from the comfort of their own homes. They’re more comfortable physically, allowing them to relax and open up to the provider. We continue to research and implement new ways to help everyone get access to the care they need to live well.

Health providers must be able to provide ease-of-use for consumers in order for them to feel comfortable and for remote solutions to be successful. By offering a telehealth solution and removing health care barriers — lack of transportation, distance to care, appointment wait times, travel time, fear of being exposed to sick patients — I believe people around the world will feel encouraged and motivated to pursue care at a faster rate in the years to come, so they can protect themselves and their loved ones. Telehealth truly is the future of care.

Markey urges bipartisanship in push to update broadband plan

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Sen. Ed Markey (D-Mass.) said Monday he is hopeful there is bipartisan support in Congress to take action on updating national broadband plans.

His statement underscored the urgency of modernizing the plan to expand internet access as the coronavirus pandemic continues to highlight the digital divide.

“I’ve always believed that, essentially, telecommunications policy is bipartisan — should be bipartisan. You have to work hard to make it ideological,” Markey said during the INCOMPAS Policy Summit.

“My hope is that we’ll be able to really move forward in a way that reflects the ultimate need for bipartisanship,” he added.

On Sunday, Markey and Rep. Anna Eshoo (D-Calif.) reintroduced the National Broadband Plan for the Future Act, coinciding with the 25th anniversary of the 1996 Telecommunications Act which transformed broadband deployment.

Markey and Eshoo’s legislation calls for the Federal Communications Commission (FCC) to update the national broadband plan in a way that addresses concerns highlighted by the coronavirus pandemic.

It would require the FCC to assess the U.S.’s progress in deploying broadband infrastructure since the 25-year-old plan was created, and develop a new roadmap for closing the digital divide.

“I’m proud of the roadmap that my previous provision created and the amazing progress we’ve made over the last decade. However, we still have a ways to go before we finish the job. During the coronavirus pandemic, we are seeing more than ever how necessary robust and affordable broadband is to the future of American life, education, jobs, and medical care,” Markey said in a statement.

Eshoo similarly called attention to issues of the digital divide emphasized by the pandemic, as professional and personal life has largely shifted online.

“From telehealth to remote learning to teleworking, high-speed internet is essential in our day-to-day lives. We must make broadband affordable and accessible for all Americans. That’s why I’m proud to reintroduce the National Broadband Plan for the Future Act to ensure all Americans have broadband,” Eshoo said in a statement.

Sen. Roger Wicker (Miss.), the top GOP member of the Senate Commerce Committee, signaled Republicans are willing to reach across the aisle to update the 1996 law.

“.@SenatorWicker looks forward to working with his colleagues to modernize aspects of the law to accelerate broadband deployment to unserved areas and promote continued investment and innovation in the communications sector,” the committee Republicans tweeted.

Housed within the 1996 law is the controversial Section 230 of the Communications Decency Act, which provides a legal liability shield for tech companies over content posted on their platforms by third parties.

Section 230 has increasingly come under fire from both sides of the aisle. Democrats argue tech companies aren’t doing enough to combat misinformation and hate speech, and Republicans have issued unsubstantiated claims that tech giants are censoring content in a way that demonstrates an anti- conservative bias.

Stay Heart Healthy with Broadband Technologies and Apps

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Broadband and heart health go together like peas and carrots. And just like how vegetables are important for a healthy diet, broadband can play a valuable role in heart health. Did you know that heart disease is the leading cause of death for men and women in the United States? Fortunately, though, heart disease is often preventable. Knowing which digital tools are available can help you take steps toward preventing heart disease today.

 

PearYour phone can help you eat a healthy diet: The food you eat goes a long way in preventing heart disease. According to the American Heart Association, a heart-healthy diet should be high in fruits and vegetables, fiber-rich whole grains, fish, nuts, and legumes and low in saturated fat and sugar. There are many recipe apps for your mobile device that can help you plan and cook heart-healthy meals. If you don’t have time for a home-cooked meal, there are also apps that let you quickly look up nutritional information about prepared foods by scanning barcodes with your phone.

scaleCalorie counting apps can help you avoid packing on the pounds: Being overweight can increase your risk of heart disease. The best way to maintain a healthy weight is to balance the amount of energy you take in (calories) with the amount of energy you release (exercise). Keeping track of calories can be tricky, but there are apps to make this easier. Calorie-counter apps help you log the food you’ve eaten and then automatically total and compare to your recommended daily calorie count.

swimWearable fitness trackers motivate you to exercise regularly: As we all know, physical activity has many heart-related benefits. These include lowering blood pressure, reducing bad cholesterol, and helping to maintain a healthy weight. Wearable, watch-like devices that monitor activity and heart rate are becoming increasingly popular for fitness. Many users report that these trackers motivate them to be active, displaying activity data on their mobile phones. Some people even share the information through social media and compare with their friends as another accountability tool for reaching their personal fitness goals.

heartmonitorWireless devices can monitor your blood pressure at home: High blood pressure is a significant risk factor for heart disease, and it can often go unnoticed. Small, wireless blood pressure monitors let you easily and quickly check your blood pressure at home. These devices measure blood pressure from the arm or wrist and send the information to a mobile phone or computer. From there, you can keep track of the results over time and even share with your doctor. This makes it easier to detect a new blood pressure problem or monitor whether a blood pressure medication is working.

Want to Know More? The Connect2HealthFCC Task Force is working to raise consumer awareness about the value of broadband in the health and care sectors. Learn about the FCC’s Connect2Health Task Force and its work on consumer health issues at www.fcc.gov/health. For information about other communications issues, visit the FCC’s Consumer website at www.fcc.gov/consumers.

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50-State Survey of Telehealth Commercial Insurance Laws

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09 February 2021

Health Care Law Today Blog

Authors: Nathaniel M. Lacktman Jacqueline N. Acosta Sarah J. Iacomini Sunny J. Levine

For years, Foley has monitored legal policy in the telemedicine and digital health industry, following how advances in technology have coupled with improved state regulations to supercharge the growth of telehealth and virtual care services in the United States. We now share the results of our 2021 50-State Survey of Telehealth Commercial Payer Statutes, which confirm significant legal advancements supporting the industry. The report provides a detailed landscape of the state telehealth commercial insurance coverage and payment laws, and is useful to healthcare providers (both traditional and emerging), lawmakers, entrepreneurs, telemedicine companies, and other industry stakeholders as a guide of telehealth insurance laws and regulations across all 50-states and the District of Columbia (D.C.).

Our first national telemedicine and digital health report was published seven years ago, with this report being our firm’s fourth publicly-available survey on telemedicine.  Our prior reports found one of the most significant barriers to adoption was limited or unclear reimbursement for telehealth and digital health services.  Enter the COVID-19 pandemic, which compelled state and federal policymakers to remove restrictions and expand reimbursement for telehealth and virtual care at a rate previously unseen. The new changes followed the previously established pathway of coverage, but the pace at which they were made was stunning. Medicare introduced nearly 100 telehealth service codes covered on a temporary basis until the Public Health Emergency expires, including payment for telephone-only consults.  States and commercial health plans followed suit.  Although some of the reimbursement expansions are temporary and slated to end when the Public Health Emergency expires, many have already become permanently codified into state law.

Foley’s 50-state survey of telehealth commercial insurance laws examines each individual state and D.C.. We provide the actual language of all the statutes and regulations and have created a multistate table and various heat maps to better illustrate the landscape and give policymakers and industry advocates a macro perspective. Our summaries and analyses reveal trends and patterns, and  highlight subtle but important differences between state law language.

Coverage Provisions

Coverage Provisions Map & Legend

While it is true that clarity of coverage and limitations on reimbursement remain  frustrations for telehealth growth, the legal landscape has materially improved. Currently, 43 states and D.C. maintain some sort of state telehealth commercial payer law; a sea change compared to a decade ago.

Reimbursement Provisions

Reimbursement Provision Map & Legend

In 2021, we anticipate more efforts among states to update their prior telehealth coverage laws to keep pace with the industry’s growth or make permanent those expansions temporarily adopted during COVID-19.

We extend our sincere gratitude to the telehealth advocacy groups, professional associations, academic medical centers, lawmakers, visionary start-ups, bold entrepreneurs, and all the individuals who have helped—and continue to help—make telemedicine and digital health what it is today.

To read the full survey, download the 2021 report.

Want to Learn More?

Visit foley.com/telemedicine for a complete list of events where members of the Foley Telemedicine and Digital Health Industry Team will be speaking.

For more information on telemedicine, telehealth, virtual care, remote patient monitoring, digital health, and other health innovations, including the team, publications, and representative experience, visit Foley’s Telemedicine & Digital Health Industry Team.

This blog is made available by Foley & Lardner LLP (“Foley” or “the Firm”) for informational purposes only. It is not meant to convey the Firm’s legal position on behalf of any client, nor is it intended to convey specific legal advice. Any opinions expressed in this article do not necessarily reflect the views of Foley & Lardner LLP, its partners, or its clients. Accordingly, do not act upon this information without seeking counsel from a licensed attorney. This blog is not intended to create, and receipt of it does not constitute, an attorney-client relationship. Communicating with Foley through this website by email, blog post, or otherwise, does not create an attorney-client relationship for any legal matter. Therefore, any communication or material you transmit to Foley through this blog, whether by email, blog post or any other manner, will not be treated as confidential or proprietary. The information on this blog is published “AS IS” and is not guaranteed to be complete, accurate, and or up-to-date. Foley makes no representations or warranties of any kind, express or implied, as to the operation or content of the site. Foley expressly disclaims all other guarantees, warranties, conditions and representations of any kind, either express or implied, whether arising under any statute, law, commercial use or otherwise, including implied warranties of merchantability, fitness for a particular purpose, title and non-infringement. In no event shall Foley or any of its partners, officers, employees, agents or affiliates be liable, directly or indirectly, under any theory of law (contract, tort, negligence or otherwise), to you or anyone else, for any claims, losses or damages, direct, indirect special, incidental, punitive or consequential, resulting from or occasioned by the creation, use of or reliance on this site (including information and other content) or any third party websites or the information, resources or material accessed through any such websites. In some jurisdictions, the contents of this blog may be considered Attorney Advertising. If applicable, please note that prior results do not guarantee a similar outcome. Photographs are for dramatization purposes only and may include models. Likenesses do not necessarily imply current client, partnership or employee status.

Authors

Nathaniel M. Lacktman

Partner

Jacqueline N. Acosta

Special Counsel

Sarah J. Iacomini

Associate

Sunny J. Levine

Associate

These were the specialties that used telehealth the most in 2020: study

By News

by Robert King

A study released this week in the journal Health Affairs gives a look at who flocked to telemedicine from January to June 2020 and what types of patients employed the technology. (Getty/airdone)

Endocrinologists and gastroenterologists were the specialty clinicians that used telemedicine the most last year during the onset of the pandemic, a new study found.

The study, released Tuesday in the journal Health Affairs, gives a look at who flocked to telemedicine from January to June 2020 and what types of patients employed the technology. The COVID-19 pandemic and new flexibility from the federal government led to massive increases in telemedicine use across the healthcare industry.

“Telemedicine use during COVID-19 varied across different clinical settings and patient populations, with lower use found among insurance enrollees in disadvantaged areas,” the study said.

Before COVID-19 hit the U.S., fewer than 2% of clinicians in each of the specialties examined used telemedicine. There was an exception among mental health clinicians like psychologists (4.4%) and psychiatrists (5.5%).

Researchers analyzed outpatient visit volume for telehealth from Jan. 1 to March 17 and from March 18 to June 16—when COVID-19 had spread—last year.

In the COVID-19 period, telemedicine was used at least once by 67.7% of endocrinologists who were surveyed, making them the clinicians that used the technology the most. Gastroenterologists (57%), neurologists (56%) and pain management physicians (50%) also were specialists that used telehealth frequently.

The specialty that used telemedicine the least was optometry, with 3.3% of clinicians using it at least once, and physical therapy was low as well at 6.6%.

Researchers also looked at the characteristics of patients who got care via telemedicine during the period. There were more than 16 million people in the sample. Nearly 80% of the patients were commercially insured, and nearly 90% of them lived in an urban area.

The study also found that telemedicine use was lowest in communities that had a higher poverty rate, with 27.9% of patients in those communities not using it. However, 31.9% of patients that did use telemedicine were from a community with a low rate of poverty.

“There are concerns that increased use of telemedicine during the pandemic may exacerbate health disparities because of the ‘digital divide’ defined as the absence of necessary broadband or smartphone technology among disadvantaged populations,” the study said.

The study comes as the healthcare industry moves to make permanent the explosion of telehealth use caused by the pandemic. Healthcare groups are pressing Congress to make some of the flexibility given by the federal government permanent.

FCC Acting Chairwoman Jessica Rosenworcel Prioritizes Visits to Hospitals in Telehealth Push

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Photo of Jessica Rosenworcel in February 2015 from New America used with permission

By:  

February 7, 2021 – Federal Communications Commission Acting Chairwoman Jessica Rosenworcel on Tuesday made a visit to Children’s National Hospital, and a virtual visit to the University of Virginia, to emphasize the agency’s goals of investing in telehealth strategies, with a specific emphasis on serving marginalized communities, veterans, and low-income patients.

Rosenworcel acknowledged that more needs to be done to connect Americans in both urban and rural areas, and that telehealth strategies are often a lifeline for areas that lack significant healthcare infrastructure, “Telehealth can help bridge the gap,” she said, “Problems can be addressed quickly, before they prove life threatening.”

This is true under normal circumstances, but the COVID-19 Pandemic “catapulted” telehealth forward. She stated that to better address the growing demand for telehealth resources, the FCC would remain committed to its goal of expanding affordable broadband access, particularly to low-income and veteran patients.

Roseworcel also emphasized that the need to provide telehealth for marginalized communities and otherwise unspecified communities that have been historically underserved was a top priority for the FCC.

The FCC has implemented several plans designed to address these concerns, and support telehealth initiatives around the country. One such initiative is the Rural Health Care Program. In 2020, the FCC announced that it would provide an additional $197.98 million to the program, providing a total of $802.7 million for the year.

Another critical initiative the FCC is using to achieve these goals is the Connected Care Pilot Program, which, among other things, emphasizes providing relief to veterans and low-income Americans. This program is now operational in 11 states with over 150 treatment sites.

The Connect2HealthFCC Task Force is continuing to engage in data collection and analysis, through initiatives such as Mapping Broadband in America, to determine which regions and communities are most at risk during the COVID-19 pandemic, and how their access to reliable internet could impact them.

Another one of the task force’s endeavors is the Broadband and Cancer Collaboration for Appalachia, a partnership between the National Cancer Institute, the FCC, and other stakeholders I the region, designed to identify how broadband connectivity can impact rural cancer patients living in underserved areas.

In addition to the initiatives they are working on, the FCC has also proposed an $18.7 million fine for those who violate the FCC’s competitive bidding rules outlined in the Rural Health Care Program. The fine would also apply to those who use or attempt to use fraudulent or misleading documentation to seek funding from the Universal Service Fund.

These programs are a part of those emphasized by Rosenworcel in her efforts to close the digital divide between Americans, not just during the COVID-19 Pandemic, but even after the crisis has subsided.

PROGRESS SEPTEMBER 2020 Orangeburg County schools helping expand health care; district teaming up with providers to offer telehealth

By News

After signing a memorandum of understanding, Palmetto Care Connections Chief Executive Officer Kathy Schwarting, left, Orangeburg County School District Superintendent Dr. Shawn Foster, center, and then-Regional Medical Center President and CEO Charles Williams come together for a celebratory fist bump.

DIONNE GLEATON T&D Staff Writer Jan 31, 2021

The Orangeburg County School District developed a mobile application that can link its students and their families with telehealth services.

OCSD partnered with Palmetto Care Connections, a Bamberg-based nonprofit telehealth network; the Regional Medical Center; Family Health Centers Inc. and Bamberg Family Practice for the creation of a S.M.A.R.T. (Students’ Medical Access to Resources in Telehealth) Virtual Health Collaborative.

School officials, along with those from partnering agencies, converged upon the district office in Orangeburg in September to announce the effort.

Under the initiative, a S.M.A.R.T. Virtual Health Collaborative app appears on all district-issued devices and leads to a webpage of telehealth providers. Students and families can also begin accessing telehealth services through the district’s website by clicking on the app and selecting a provider of their choice.

S.M.A.R.T. can also be accessed directly through the following link: www.ocsdsc.org/telehealth. Individuals can also simply go to www.ocsdsc.org, click on Quick Links at the bottom right of the page, scroll down to Parent/Student Resources and click on OCSD – SMART Virtual Telehealth.

OCSD Superintendent Dr. Shawn Foster said it is critical to provide access to health care services to individuals who are not only without transportation, but the necessary technology to access the services remotely.

Foster recalled speaking with then-RMC Chief Executive Officer Charles Williams about the challenge.

“I recall Mr. Williams and his epidemiologist were talking about some of the struggles that they were having here in the community in regard to access, that he had people in this community calling in, wanting to see a doctor,” Foster said.

If the caller said they didn’t have transportation, “the hospital then followed up and would ask, ‘Well, do you have a device to use?’ They said, ‘Well, I don’t have a device. I don’t even have a smart phone.’ So they found themselves in a challenging situation, where they were trying to provide services over the phone, which is not an ideal circumstance,” he said.

Foster said it wasn’t long before the FHC came on board with the telehealth initiative.

An opportunity existed that allowed OCSD to fill a gap in providing services, he said.

“I’ve said since day one that I hope to have Orangeburg in a space where our education is no longer product-driven, that we’re solution-driven.

“When I say product-driven, I mean it’s more than about getting 24 credits and getting a high school diploma. It’s about being an educational institution that is willing to seek solutions to gaps that we have in our community,” he said.

The superintendent thanked the other community partners such as Palmetto Care Connections and its staff, including Director of Technology Matt Hiatt.

PCC is seeking to expand the list of providers in the S.M.A.R.T. Virtual Health Collaborative. There is no expense to medical entities for participation in the collaborative, but there is a request that they provide professional and patient care to those they serve.

PCC Chief Executive Officer Kathy Schwarting said, “Our whole purpose and mission in life is to make sure that rural and underserved communities have access to care. I’ve spent 25 years in rural health care, and I’ve always said that your zip code should not define the quality of service you have, the type of service, or the quality of the life that you live.”

“If you want to live in Orangeburg, Bamberg, Allendale, you should still have access to the same high-quality services. That’s what PCC is built on. … We have helped lots of rural communities in the state implement school-based telehealth, but not with the vision that Dr. Foster has had. So I’m very grateful for that,” Schwarting said.

Pickens Co. passes ordinance to better broadband in underserved areas

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by:

Posted: Updated:

PICKENS COUNTY, SC (WSPA)– Approximately $1.6 million will be used to fix some major broadband issues in Pickens County. Many families said the lack of connectivity is a big problem in several areas.

On Monday, the Pickens County Council passed an ordinance to better broadband through an initiative.

“Actually, it’s been very hard,” Jane Wright said. “I can’t even explain how hard it’s been, but it’s been very very hard,” she said.

In an age where a bedroom is the new classroom, and most living rooms are now offices, some like Wright have had problems getting connected.

“I live at the edge of town and I’m ineligible to receive services from Spectrum or from regular AT&T service because the bandwidth where I live at is not strong enough or high enough for me to even have a plan,” Wright said.

Pickens County Administrator Ken Roper said, they noticed the issues last Spring when people were in lockdown during the pandemic.

“When everything was locking down and people were having to talk about doing school from home, or work from home, or telemedicine, and all of those sorts of things, and we started recognizing that you know, we don’t have the internet connectivity in this county that lets us do that sort of thing,” Roper said.

Now, an agreement with Blue Ridge Electric Cooperative Inc., will help with the problem.

“We were able to incentivize the co-op, pay the co-op to connect our buildings and to take those broadband lines through those underserved communities. We’re very excited about this,” Roper said.

Eight different areas in Pickens County have been identified as underserved.

“Those eight areas have relatively high concentration of people, and relatively low access to internet. So they’ve got 20-year-old technology like dial-up internet,” Roper said. “The worst place for that is kind of Highway 93, passed Liberty, towards Norris and the Cateechee community. That area has a lot of people in it, but not a lot of access to broadband,” Roper said.

Some county facilities will help boast the entire community.

“In August, we came up with an idea. That idea was to see if we could find a community partner, someone in the broadband industry, to connect our facilities, the county facilities like the fire departments, the libraries, the recycling centers, the airport. And by connecting those facilities, could we get broadband in those communities that don’t have it,” Roper said.

Roper said the county already has a budget for the broadband initiative.

“The good news there is that Pickens County has a capital reserve, a fund balance is a better way to put it. We have money in the bank. We’ve saved for a rainy day because we’ve been very frugal through the years. So what we’re basically telling Blue Ridge Co-op is, that if you will run the lines in the areas that we know are needing the service the most, that we will reimburse you for each of these eight blocks. Each of these eight areas that are underserved, we will reimburse you $200,000 per area, to run the lines to our facilities,” Roper said.

Now the funding will be a band-aid for many.

“It will be very beneficial, because like I said, a lot of people in the area that I live in, which is on the edge of town, people have no service,” Wright said.

Roper said by the end of the year, Blue Ridge Co-Op plans to have broadband lines up for areas like Liberty and Norris. Once completed, the Sunset community, Dacusville, and Pumpkintown areas will be next in the following months.

Acting Health & Human Services Secretary Signals Extension of PHE through 2021

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The Acting Secretary for the U.S. Department of Health & Human Services (HHS) indicated in a recent letter to state Governors that the Department intends to extend the declaration of a Public Health Emergency (PHE) through at least the end of 2021. The Public Health Service Act grants HHS broad authority to issue a PHE declaration that remains active for a 90-day period. In 2020, HHS took a wait-and-see approach to reauthorizing the PHE declarations it issued in response to the COVID-19 pandemic. This meant reevaluating the PHE declaration based on the evolving situation and reauthorizing the PHE declaration near the end of each 90-day period. In addition, the Acting Secretary indicated in the letter that the Department will provide states a 60-day notice prior to the termination of the PHE declaration.

In the Acting Secretary’s own words, this shift is intended to bring “predictability and stability” to states and their public health programs, many of which have tied expiration of their telehealth expansions to the federal PHE declaration. The letter specifically highlights the flexibilities that the PHE declaration affords for the provision of telemedicine services to Medicaid and Medicare beneficiaries. For state Medicaid programs, this will also create some budget certainty with an extension of the Federal Medical Assistance Percentage (FMAP) rate increase set to expire at the end of the PHE.

Current Medicare telehealth flexibilities, such as the removal of the rural requirement and expansion of certain procedure codes and telephone visits, are all scheduled to sunset once the PHE declaration is rescinded. Medicare expanded additional Category 3 procedure codes in the 2021 Physician Fee Schedule that will sunset at the end of the calendar year in which the PHE declaration is terminated (see CCHP’s Physician Fee Schedule Fact Sheet for more information). Based on the Acting Secretary’s letter, this could mean that these flexibilities and expanded services will all sunset by the end of 2021 unless Congress passes legislation to codify them.

The announcement is also likely to have an impact on some private payer’s temporary telehealth policies. A recent Center for Connected Health Policy report titled, An Analysis of Private Payer Telehealth Coverage During the COVID-19 Pandemic, found that several of the largest national insurers that temporarily expanded their telehealth coverage or waived cost sharing for telehealth services tied their expiration to the federal PHE declaration. Under the Families First Coronavirus Response Act (FFCRA), private payers are also required to cover telehealth services that are associated with a COVID-related diagnosis through the end of the PHE.

For more information, view the full letter from the Acting Health & Human Services Secretary.