Telemedicine Updates from Washington, DC

We want to report on two recent telehealth-related stories. First, the Medicare Payment Advisory Commission (MedPAC) appear to be split about how to move forward with telehealth after the COVID-19 public health emergency. Additionally, in a late move from the Trump Administration, $8 million was recently allocated to a telehealth broadband pilot program.

MedPAC Torn on Telehealth

Members of MedPAC, an influential congressional advisory committee on Medicare, appear torn on how best to regulate telehealth after the COVID-19 public health emergency, hinting at the difficulty Washington faces as it looks to impose guardrails on virtual care without restricting its use after the pandemic ends. During a January virtual meeting, MedPAC expressed its support of telehealth broadly, but many members noted snowballing use of the new modality could create more fraud and abuse in the system down the line. Key questions of how much Medicare reimburses for telehealth visits and what type of visits are paid for won’t be easily answered, MedPAC commissioners noted.

“This is a really, really difficult nut to crack,” Michael Chernew, MedPAC chairman and a healthcare policy professor at Harvard Medical School, said.

“I don’t think what we’ve done with the pandemic can be considered pilot testing. I think a lot of this is likely to go forward no matter what we do because the gate has been opened, and it’s going to be really hard to close it,” Marjorie Ginsburg, founder of the Center for Healthcare Decisions, said. But “I see this just exploding into more fraud and abuse than we can even begin imagining.”

Trump Administration Rolled out Money to Improve Rural Telehealth

We had not covered this previously, but want to note the Trump administration’s $8 million for improvements to telehealth services via broadband in rural areas. It was announced in early January.

The Health Resources and Services Administration (HRSA), part of the Department of Health and Human Services, awarded the funding to the Telehealth Broadband Pilot (TBP) program. That program will assess the broadband capacity available to rural health care providers and patient communities to improve their access to telehealth services.

“HHS has made it a priority to transform rural healthcare, including through innovations like telehealth, where we’ve seen many years’ worth of progress in just the past year,” said HHS Deputy Secretary Eric Hargan in a statement.

“As someone who hails from rural America, supporting delivery of care in the most remote parts of America, like Alaska, is a personal passion of mine, and telehealth is a crucial part of that work. This telehealth pilot program is part of the Rural Action Plan that HHS launched this past year, which lays out a path forward to coordinate agency efforts to transform and improve rural health care in tangible ways.”

The majority of the funds, $6.5 million, will go to the National Telehealth Technology Assessment Resource Center (TTAC) to improve telehealth access in Alaska, Michigan, Texas, and West Virginia.

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