Telehealth Archives | Page 18 of 36

Telehealth

Slow and Steady – CMS Expands Telehealth Reimbursement Opportunities in 2018

by McDermott Will & Emery and Lisa Mazur | Dec 7, 2017 | Big Data, Mobile Apps, Telehealth

The Centers for Medicare & Medicaid Services (CMS) reiterated its commitments to expanding access to telehealth services and paying “appropriately” for services that maximize technology in the Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings Program Requirements; and Medicare Diabetes Prevention Program Final Rule published on November 15, 2017 (the Final Rule). Among many other developments, the Final Rule expands allowable telehealth reimbursement under the calendar year (CY) 2018 Physician Fee Schedule, List of Medicare Telehealth Services (list) and permits virtual sessions in certain circumstances under the Medicare Diabetes Prevention Program Expanded Model (MDPP, or the Program). The regulations are effective January 1, 2018.

“New” and “Add-On” Telehealth Services Slated for Reimbursement

CMS evaluates requests for the addition of telehealth services on the basis of two categories: (1) services that are similar to services already on the list and (2) services that are not similar to services already on the list. An evaluation of a category (2) service requires CMS to assess, based on the submission of evidence, whether the use of a telecommunications system to furnish the service “produces demonstrated clinical benefit to the patient.” (more…)

ONC’s De-Regulatory Announcement Aims at Enticing Industry to Adopt 2015 Edition Criteria

by Scott Weinstein | Nov 6, 2017 | Big Data, Consumer Protection, Cybersecurity, Mobile Apps, Telehealth

In September, the Office of the National Coordinator for Health Information Technology (ONC) announced that it is scaling back requirements for third-party certification of criteria related to certified electronic health record (EHR) technology (CEHRT). Going forward, ONC will allow health developers to self-declare their products’ conformance with 30 of the 55 certification criteria.

ONC will also exercise discretion and not enforce the requirement that certification bodies conduct randomized surveillance of two percent of the health IT certifications they issue.

Read “ONC’s De-Regulatory Announcement Aims at Enticing Industry to Adopt 2015 Edition Criteria.”

Declaration of Public Health Emergency Changes Remote Prescribing Requirements but Creates Many Questions Waiting to Be Answered

by McDermott Will & Emery, Lisa Mazur and Marshall E. Jackson, Jr. | Oct 26, 2017 | General Interest, Telehealth

President Trump declared the opioid addiction epidemic a public health emergency yesterday. The White House made it clear that this declaration would allow officials to remove barriers to the prescribing of controlled substances via telemedicine, which would permit DEA registered providers to prescribe anti-addiction medications, such as Naloxone, to patients in need without first performing an in-person exam.

As background, the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (the Haight Act) requires a telemedicine provider who is prescribing a controlled substance to a patient to perform an in-person medical evaluation of the patient prior to prescribing a controlled substance, unless one of the narrow telemedicine exceptions set forth in the Haight Act applies. Additional information on the Ryan Haight Act and the implications of this declaration can be found here.

There are many important questions remaining to be answered, including whether any funding will be available to support the implementation of this declaration and whether the declaration will be renewed upon its expiration in 90 days. The answers to these questions are important to healthcare providers who will need to invest resources and time into developing telemedicine programs to reach more substance use disorder patients, which may take longer than 90 days to implement.

Virtual Care Advancement | Outlook on CHRONIC Care Act and Other Federal Legislation

by Adam Marks, Lisa Mazur and MaryKathryn Hurd | Oct 26, 2017 | Telehealth

The Senate’s unanimous passage of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (S.870) on September 26th is an encouraging step forward for modernizing telehealth access and reimbursement. The bipartisan, budget-neutral bill aims to improve health outcomes for Medicare beneficiaries living with chronic conditions and includes key provisions expanding access to telehealth. A summary of the key telehealth provisions under the CHRONIC Care Act can be found here.

The bill now moves to the House Subcommittee on Health and may be adopted in its current form or integrated into existing House bills. The House has already advanced three separate bills this year with telehealth provisions similar to those included in the CHRONIC Care Act: expanding telehealth services under Medicare Advantage (HR 3727), expanding telehealth for stroke patients (HR 1148), and expanding the use of telehealth to facilitate the use of home dialysis (HR 3178). With seemingly aligned goals between the two chambers, the House may accept the remaining provisions of the CHRONIC Care Act, or negotiate minor changes and incorporate the CHRONIC Care Act into another priority health care related bill, such as extending federal funding for the Children’s Health Insurance Program, as a vehicle for passage this calendar year.

The recent momentum of federal legislation focused on expanding telehealth services to Medicare beneficiaries signals Congress’ continued consideration of telehealth’s ability to improve patient health and lower the costs of health care delivery. In light of this increased legislative activity, health care providers, commercial payers and telehealth technology companies should be mindful of the following.

Consider developing or participating in studies designed to test the efficacy and efficiency (including costs) of telemedicine programs.
Continue exploring ways to tailor their care delivery and revenue models to provide telehealth services to Medicare beneficiaries.
Offer Center for Medicare and Medicaid Services (CMS) and MedPAC insights and guidance on ways to provide the Federal government agencies overseeing Medicare coverage and payment for telehealth services the best available industry information.
Focus operational goals to achieve cost and value goals that are of concern to the government.

Upcoming FTC Workshop on Informational Harm | Next Brushstrokes on the FTC’s Consumer Privacy and Security Enforcement Canvas

by McDermott Will & Emery and Bernadette M. Broccolo | Oct 25, 2017 | Consumer Protection, Cybersecurity, Data Privacy, Telehealth

On September 29, the Federal Trade Commission (FTC) formally announced a December 12th workshop on informational injury—the injury a consumer suffers when information about them is misused. The workshop will address questions such as, how to characterize and measure such injury and what factors businesses and consumers should consider the benefits and risks of collecting, using and providing personal information so as to gain further perspective for how the FTC should apply its legal framework for privacy and security enforcement under 15 USC § 45 (Section 5). In her September 19th remarks to the Federal Communications Bar Association, Commissioner Maureen Ohlhausen, the Acting Chairman of the FTC, metaphorically characterized the workshop’s purpose as providing the next brushstrokes on the unfinished enforcement landscape the FTC is painting on its legal framework canvas. The full list of specific questions to be addressed may be accessed here.

Background. The FTC views itself as the primary US enforcer of data privacy and security, a role it recently assumed. While the FTC’s enforcement against practices causing informational injury through administrative proceedings goes back as far as 2002, its ability to pursue corporate liability for data security and privacy practices under its Section 5 “unfair or deceptive trade practices” jurisdiction was only ratified in 2015 by the US Court of Appeals for the Third Circuit in FTC v. Wyndham Worldwide Corporation. The FTC has actively invoked its enforcement authority but, in doing so, has been selective in determining which consumer informational injuries to pursue by questioning the strength of evidence connecting problematic practices with the injury, examining the magnitude of the injury and inquiring as to whether the injury is imminent or has been realized. (more…)

The Opioid Crisis: Declaring a National Emergency and the Effect on Remote Prescribing through Telemedicine

by McDermott Will & Emery, Lisa Mazur and Marshall E. Jackson, Jr. | Oct 20, 2017 | Telehealth

On July 31, 2017, President Donald Trump’s Commission on Combating Drug Addiction and the Opioid Crisis recommended that he declare the opioid epidemic a national emergency. In August 2017 and again on October 16, 2017, the president indicated he would declare the opioid crisis a national emergency. While it is apparent that the nation is suffering a drug overdose and opioid-specific crisis, the question remains as to what effect such a declaration would have on combatting the crisis.

The president’s powers to declare a national emergency arise from the Stafford Act, and once a national emergency is declared, it enables 1) access to US Department of Homeland Security ‒ Federal Emergency Management Agency (FEMA) funding, with states able to request grants for the specific purposes of treating opioid addiction; 2) the ability to re-appropriate federal agency workers, such as those employed by the agencies under the US Department of Health and Human Services (HHS) umbrella, to specifically research and treat opioid addiction; and 3) waiver of federal Medicaid regulations to provide additional aid to beneficiaries, ensuring sufficient health care items and services are available to meet the needs of beneficiaries. Such a declaration would undoubtedly open up both federal and state governments to formulate a comprehensive, unified strategy to combat the opioid epidemic sweeping the nation. (more…)

Texas Continues to Embrace Telemedicine

by Lisa Mazur, Marshall E. Jackson, Jr. and Olivia J. Jahn | Oct 10, 2017 | Telehealth

On September 15, 2017, the Texas Medical Board (Board) released proposed rules regarding telemedicine and mental health services (Proposed Rules) to implement Senate Bill 1107, which was passed on May 11, 2017. Most notably, the Proposed Rules provide that a physician-patient relationship can be established solely by the delivery of care via telemedicine services and eliminates the prior requirement that services for new patients be provided at an established medical site and with a telemedicine presenter. These changes to the Board’s approach create the same standard of care for in-person and telemedicine services.

McDermott previously r eported on Senate Bill 1107 and provided relevant background on telemedicine in Texas. The Board is accepting public comments on the Proposed Rules. A public hearing regarding the Proposed Rules will be held at a later date to be determined.

In addition, the Texas Health and Human Services Commission (HHSC) recently adopted final rules regarding the reimbursement of telemedicine in Texas Medicaid (Final Rules) on October 6, 2017. The Final Rules are effective as of December 1, 2017. (more…)

Home Care: The Digital Health Opportunity

by Dale C. Van Demark | Oct 2, 2017 | Telehealth

A recent article in Kaiser Health News highlights the health risks associated with the increased effort to get patients home—namely, the need for families to gain and effectively deploy the skills needed to care for themselves and family members. The article highlights the risks (and increased rates) of infections, particularly in relation to catheters. However, it does not take much imagination to identify other conditions where at home care is critical.

Concise and easy to follow instructions are key, of course, but information technology can play a role here as well. While the business plan for this type of digital health strategy may not be as clear as others, this is the type of sector that could demonstrate the digital health opportunity in the effort to increase value in health care delivery.

The Way Forward for Telemedicine

by Dale C. Van Demark | Sep 25, 2017 | Telehealth

A lot of us have argued that one of the floodgates for telemedicine has been reimbursement. If states and the Federal government more liberally reimbursed or required reimbursement for telemedicine service, we argue then a significant barrier to broader telemedicine will be removed. This is a valid argument, and the potential flurry of activity on Capitol Hill as of this writing (September 20, 2017) gives many hope that Medicare reimbursement for telemedicine may be greatly expanded soon.

Alas, another problem persists. A spate of recent surveys and reports on utilization demonstrate that awareness should be viewed as a similar sort of barrier. It is, of course, a generalization to say this, but consumers are largely unaware of the benefit being made available to them, or are unaware of the appropriate uses of a telemedicine service. It would be foolish to speculate as to the reasons why, but a recent trend may help to erode this barrier.

When it comes to customer service and user engagement, none are better than our technology industry. The West Coast tech giants clearly understand how to engage and attract users. The remarkable success of smart phones provides ample evidence—can you think of any other consumer product of comparably high-cost being as ubiquitous? It is also clear that the health care industry has failed to engage consumers as effectively. There are likely multiple reasons for this. Health care is: (1) highly regulated, resulting in limited ability to be quickly responsive to consumer demands; (2) run by professionals trained in many things, but not sales or consumer satisfaction and engagement; and (3) burdened both by a lack of competition at the point of sale, and by a third-party payment system that has so far proven to be impervious to the forces of disintermediation. (more…)

Artificial Intelligence in Health Care: Framework Needed

by McDermott Will & Emery and Dale C. Van Demark | Sep 15, 2017 | Advertising & Marketing, Cybersecurity, Data Privacy, General Interest, Telehealth

Although the incorporation of technology into human endeavours—commercial, political and personal—is a normal component of technological innovation, the advent of artificial intelligence technology is producing significant challenges we have not felt or understood with earlier innovations. For many years, for example, there has been speculation, research and public debate about the impact of the internet, the functioning of search engines, and online advertising techniques on commercial and political decisions.

The alleged “hacking” of the 2016 US presidential election, and the concerns about such activities in the 2017 European elections, will only heighten the interweaving discussions on free speech, national sovereignty, cyber security and the nature of privacy.

The use of artificial intelligence and machine-learning technologies has only added to the list of issues and areas of concern. The consequences of automobile accidents involving “self-driving” technologies, the “flash crashes” on securities markets due to algorithmic trading, and bias in systems designed to determine benefit eligibility, are requiring us to consider what happens when we defer judgment to machines, and highlighting the importance of quality in data sets and sensors.

Read Full International News, Fall 2017