On March 12, 2019, the Congressional Telehealth Caucus, together with a bipartisan group of Senators, published a request for information (RFI) asking for help and guidance in crafting “comprehensive telehealth legislation for the 116th Congress.” The Caucus is seeking input from the public as it relates to its goal of “assembling a revised telehealth package that continues to expand access to vital, cost-efficient telehealth and remote monitoring services across the country.”
The letter notes that the group is hoping to build on former successes and is seeking “recommendations on policy areas most likely to prompt Congressional action, including ideas that are fiscally responsible and able to generate bipartisan support.”
The RFI specifically requests input on recommendations that would:
- Expand access to telehealth and remote monitoring, especially in rural or otherwise underserved communities;
- Improve patient outcomes, whether by expanding access to specialists or other providers or by easing the day-to-day patient experience;
- Encourage easier and expanded use of existing telehealth and remote monitoring technologies, many of which suffer from low uptake rates; and
- Reduce healthcare costs for both patients and federal programs, including Medicare.
When submitting comments, the Caucus asks that “existing data or records demonstrating the success of or otherwise supporting the recommendations” are included, so as to bolster the potential passage of legislation including the ideas.
Alston & Bird Advisory and Suggestions
Alston & Bird, LLP issued an advisory on March 25, 2019, that mentions some possible legislative and/or regulatory actions that may help to encourage “wider telehealth adoption, promote access to care, and improve patient outcomes through technology-enabled health care.”
One idea included in the advisory is the recommendation that rural restrictions continue to be removed to allow for telehealth services to be provided to an expanded reach of patients in urban areas. The advisory notes that Congress has been working at slowly removing this restriction, including removing geographic requirements for home dialysis end-stage renal disease and telestroke treatment effective January 1, 2019, and for substance abuse treatment effective July 1, 2019.
Another recommended possibility is to bring a consistency to remote patient monitoring. The advisory references the inconsistencies in CMS’ announcement regarding reimbursement of remote physiologic monitoring and the reversal of a decision regarding when such reimbursement is permitted, based on who provides the RPM services. Alston & Bird note that in this instance, CMS may be in the best position to resolve these inconsistencies, congressional action may prove to be helpful.
Another concept mentioned in the advisory, and one that has been previously mentioned by several in the health care arena, is to highlight additional opportunities for the adoption of telehealth and virtual services. This legislation can be as focused or wide-ranging as Congress is comfortable with, but it is likely that Congressional action on furthering the adoption of telehealth and telemedicine would go a long way to making it more commonplace.
Comment Submission
The Telehealth Caucus, launched in May 2017, has put forth several telehealth and telemedicine bills over the course of that time period, including the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) Act of 2017, parts of which were folded in to the Bipartisan Budget Act of 2018.
All comments in response to the RFI are due Monday, April 1, 2019. Comments can be emailed to Telehealth.RFI@mail.house.gov.