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October 2021

ATA to assess telemedicine’s role in addressing U.S. healthcare disparities

By News

Photo: Thomas Barwick/Getty Images

Source: Healthcare IT News

By Kat Jercich

The American Telemedicine Association announced this week that it was launching a new initiative aimed at evaluating telehealth’s potential as a tool to address and eliminate health disparities in the United States.

The CEO’s Advisory Group on Using Telehealth to Eliminate Disparities and Inequities, comprising more than 30 executives from a range of payer, provider and tech organizations, issued a framework alongside the announcement that will serve as the foundation of ongoing strategic analysis and future policy recommendations.

“In recent years, we have seen rapidly growing evidence that telehealth services can and should play a central role in strategies to address health disparities in the U.S.,” said Ann Mond Johnson, CEO of the ATA, in a statement. “Our new ATA CEO’s Advisory Group brings together globally recognized leaders in health policy and service delivery who are uniquely positioned to outline the optimal strategies to use telehealth to address this very significant challenge.”


The advisory group is chaired by Kristi Henderson, CEO for MedExpress at Optum; Yasmine Winkler, independent director at GEHA Health; and Dr. Ron Wyatt, VP & safety officer at MCIC Vermont.

Its members include representatives from Kaiser Permanente, Intermountain Healthcare, Fenway Health, UnitedHealth, Facebook, Microsoft Health and Salesforce, along with other stakeholders.

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CCHP’s Fall 50 State Telehealth Policy Summary Report is Here!

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Source: Center for Connected Health Policy – The National Telehealth Policy Resource Center

…Telehealth Policy Shifts Again!!

Today the Center for Connected Health Policy (CCHP) is releasing its bi-annual summary of state telehealth policy changes for Fall 2021. Additionally, we are also making available a summary chart showing where states stand on many key telehealth policies, as well as an infographic highlighting our key findings. Historically, CCHP has released twice a year (Spring and Fall) updates to its “State Telehealth Laws and Reimbursement Policies” report in the form of a PDF report document that details all the telehealth policies for all 50 states and the District of Columbia.

Over the years this has evolved to include an update to CCHP’s online database of the same information. In Spring 2021, the policy database transitioned exclusively to a new and improved online Policy Finder tool. This online database tool allows CCHP to easily update each state’s information on a more frequent basis instead of updating only in the Spring and Fall. Additionally, while there will no longer be a single PDF report with every state, the information from the online database can now be exported for each state into a PDF document using the most current information available on CCHP’s website. The information for this summary report covers updates in state telehealth policy made between June and September 2021.

Please note that many states continue to keep their temporary telehealth COVID-19 emergency policies siloed from their permanent telehealth policies. These temporary policies are not included in this executive summary, although they are listed under each state in the online Policy Finder under the COVID-19 category. In instances where the state has made policies permanent, or extended policies for multiple years, CCHP has incorporated those policies into the summary.

Highlighted Findings

The main areas where changes were made since our Spring 2021 update fall in the three buckets that CCHP uses to categorize information within its policy finder: (1) Medicaid policy, (2) private payer policy, and (3) regulation of health professionals. Changes were also highly influenced by temporary expansions made during the COVID-19 pandemic. Some states took approaches to extend their pandemic policies multiple years into the future, while others made policies (or portions of their COVID policies) permanent. Still others have not adopted their more lenient COVID policies at all.

In Medicaid, it was common for states to make slight adjustments to their telehealth policies to add or clarify the services that can be delivered via telehealth, types of professionals that can deliver care through telehealth or the types of settings a patient can be in during a telehealth interaction. For example, Mississippi clarified that Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC) and community mental health centers can be originating and distant sites, and Arkansas now specifies that both the home is an eligible patient site and that group meetings may be performed via telemedicine. Although reimbursement for audio-only telephone has become pretty standard during the COVID-19 public health emergency (PHE), less than half of state Medicaid programs explicitly are reimbursing for the modality permanently, though that number has increased since Spring 2021. Many state Medicaid programs that have added audio-only coverage have placed restrictive parameters around its reimbursement.

Many states also made modifications to their telehealth private payer reimbursement law language to alter the definition of telehealth/telemedicine. This typically included an expansion of the definition to be broader in scope so that it entails more than just live video, although often with some caveats. For example, Arkansas’ private payer law now stipulates that telemedicine does not include audio-only communication, unless the audio-only communication is real-time, interactive, and substantially meets the requirements for a healthcare service that would otherwise be covered by the health benefit plan. Requirements around payment parity were also a common change, with eight states passing a law requiring the same reimbursement amount whether a service is provided via telehealth or in-person since Spring 2021. Illinois, for example, now requires reimbursement parity for in-network or tiered network health care professionals or facilities, including services provided via audio-only.

Finally, there is a noticeable shift in telehealth policy towards tightening of professional requirements around the use of telehealth by providers. For example, Michigan passed new consent requirements for social work, athletic trainers, massage therapists, acupuncturists and veterinary medicine, and West Virginia adopted emergency telehealth practice standard regulations for five professions, including dentistry, nursing, osteopathic medicine, social work and medicine. While many states have had these types of standards for several years, the rate at which new telehealth standards are being adopted has increased significantly within the last six months. States that offer special licenses or certificates or have exceptions to licensing requirements related to telehealth has also slightly increased since Spring 2021. For example, Florida and Arizona are two states that have recently relaxed their licensing requirements, requiring out-of-state telehealth providers to only register with their applicable professional board within the state. Additionally, at least ten states entered into licensing compacts since Spring 2021.


Fifty states and Washington, DC provide reimbursement for some form of live video in Medicaid fee-for-
Twenty-two states provide reimbursement for store-and-forward.
Twenty-nine state Medicaid programs provide reimbursement for remote patient monitoring (RPM).
Twenty-two states allow for telephone reimbursement, although in most cases it is extremely limited.
Fourteen states limit the type of facility that can serve as an originating site.
Thirty-five state Medicaid programs offer a transmission or facility fee when telehealth is used.
Forty-three states and DC currently have a law that governs private payer telehealth reimbursement

Complete information by state can be viewed on CCHP’s Policy Finder Look Up page. In addition, CCHP will continue to make available bi-annually an infographic, state summary chart and an analysis report summarizing changes. The report is available on the web, and in PDF form.

Biden Administration Emphasizes Telehealth in its Infrastructure Strategy

By News

Source: mHealthIntelligence

By Eric Wicklund


While Congress is whittling down the Biden Administration’s massive Build Back Better plan, new announcements out of the USDA and FCC aim to support broadband expansion for telehealth – and to emphasize how important that is to the nation’s infrastructure

– The federal government is making a concerted effort to link broadband connectivity and telehealth to the nation’s infrastructure.

The Us Department of Agriculture last week unveiled more than $1.15 billion in federal loans and grants for broadband expansion in rural regions, alongside $50 million in funding for 105 distance learning and telemedicine projects in 37 states and Puerto Rico. This announcement came on the same day that the Federal Communications Commission unveiled $40.5 million for 71 more projects in the COVID-19 Telehealth Program, and at the same time that the FCC is getting ready to announce more award winners in its Connected Care Pilot Program.

All of these efforts come as the Biden Administration is putting pressure on Congress to support its Build Back Better plan for infrastructure improvements.

In the USDA announcement, USDA Secretary Tom Vilsack emphasized the federal action as a means of addressing barriers to care and other services in rural America.

“For too long, the ‘digital divide’ has left too many people living in rural communities behind: unable to compete in the global economy and unable to access the services and resources that all Americans need,” he said in a press release. “As we build back better than we were before, the actions I am announcing today will go a long way toward ensuring that people who live or work in rural areas are able to tap into the benefits of broadband, including access to specialized healthcare, educational opportunities and the global marketplace. Rural people, businesses and communities must have affordable, reliable, high-speed internet so they can fully participate in modern society and the modern economy.”

Telehealth advocates have long argued that broadband connectivity is a significant challenge to connected health adoption, and that healthcare organizations won’t expand their platforms if they can’t guarantee a reliable connection with patients. Likewise, access to telemedicine technology and an understanding of how to use it are considered social determinants of health, non-clinical factors that influence health outcomes.

The USDA’s DLT grants have long been used to address rural connectivity for both healthcare and education, and the award winners are often an even mixture of healthcare providers and schools. Vilsack’s announcement last week highlighted the healthcare side, noting that Illinois-based OSF HealthCare is getting $387,000 to establish a telehealth network to serve more than 100,000 rural patients and United Health Services of Texas is getting almost $200,000 to improve its telemental health platform for 8,000 residents of Oklahoma’s Choctaw and Chickasaw Nations.

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New Bill Targets Telehealth Provisions in High-Deductible Health Plans

By News

Source: mHealthIntelligence

By Eric Wicklund

A bill introduced in the House earlier this month would extend provisions for telehealth coverage in high-deductible health plans that were enacted in the CARES Act of 2020, but are due to expire at the end of this year.

– A new bill before Congress aims to improve telehealth coverage, particularly for primary care services, in high-deductible health insurance plans.

The Primary and Virtual Care Affordability Act (HR 5541), introduced earlier this month by US Reps. Brad Schneider (D-IL) and Brad Wenstrup (R-OH), would extend through 2023 a provision in the CARES Act that established first-dollar coverage for telehealth services in HSA-eligible HDHPs. It would also give HDHPs the leeway to waive the deductible for primary care services.

“Financial burdens should not prevent Americans from seeing their primary care doctor to discuss critical health care needs,” Schneider said in a press release. “The upfront costs of high-deductible health plans discourage too many Americans from getting the preventative care they need, leaving issues untreated and ultimately resulting in higher costs and poorer outcomes down the line.”

Estimates place the number of Americans with HDHPs at more than 35 million – or roughly 30 percent of all covered workers. The plans offer attractive low monthly premiums, but set high deductibles that the plan holder must pay out of pocket before the insurance kicks in.

Telehealth advocates point out that those high deductibles can be barrier to accessing care, particularly for those with limited incomes. The Alliance for Connected Care, which supports the bill, points out that more than half of those with an HSA live in areas where the median income is below $75,000, making it difficult to reach the $1,400 individual and $2,800 family thresholds that trigger coverage.

Recognizing that concern, Congress included a provision in the CARES Act, passed in 2020, that enabled employers to create a safe harbor from certain HDHPs during the pandemic, enabling them to offer free or reduced-cost access to telehealth services. But that provision will end at the end of this year.

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Sponsored South Carolina Telehealth Alliance Partners with ReferWell to Expand Access to Specialist-Informed Care Across South Carolina

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Source:  ReferWell

CHARLESTON, S.C. and STAMFORD, Conn., Oct. 20, 2021 /PRNewswire-PRWeb/ — South Carolina Telehealth Alliance (SCTA), in partnership with ReferWell, a fast-growing health technology company driving efficient care transitions through the last mile, today announced the launch of South Carolina eConsult, an initiative that aims to improve South Carolinians’ health outcomes, no matter where they live, by helping the residents and their physicians access specialist-informed care.

Through ReferWell’s EMR-agnostic platform, providers at health centers and group practices across the state can request asynchronous virtual consultations with experts in several specialties to determine the appropriate next step in their patient’s care journey—improving the quality of care and making it easier for patients to access the care they need with less effort.

“We are thrilled to offer local physicians a free tool to get quick, expert guidance to solve cases and avoid unnecessary patient visits without their staff spending time on the phone,” said Dr. James McElligott, SCTA Advisory Council co-chair.

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Fall Ushers in New State & Federal Policy Developments

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Source: Center for Connected Health Policy

State COVID-19 Flexibilities Slowly Subsiding

As part of CCHP’s Telehealth Policy Finder, we track COVID flexibilities by state for eight topic areas, including Medicaid reimbursement (site, provider type, service and modality expansions), COVID specific requirements for private payer telehealth coverage and COVID-related flexibilities related to prescribing, consent and cross-state licensing requirements.  In recent weeks, CCHP has noted that many state-based waivers and flexibilities are slowly beginning to subside.  An example of this is in Ohio.  There, the Medical Board recently voted to resume enforcing a regulation that requires a physician to have an in-person exam prior to prescribing a controlled substance starting December 31, 2021.  The policy is confirmed in a recently updated state Medical Boards FAQs document.  Another example is in California, where the Governor has extended a previous COVID related executive order to facilitate telehealth services, but rescinds a section of the executive order suspending a requirement for providers to obtain verbal or written consent before the use of telehealth. While these states are reverting back to previously existing policies, some states have passed expanded telehealth policies that are either permanent or have sunset dates a few years down the line.  These states are often allowing their COVID temporary policies to expire with the knowledge of the permanent (or multi-year) policy now in place. An example includes Arizona rescinding their executive order related to insurance reimbursement due to passage of HB 2454 which made many of the requirements of their COVID era policy permanent.  Still other states are continuing with two policies, one applicable during the public health emergency (PHE) and the other permanent, such as South Dakota Medicaid, which incorporates both permanent and temporary policies into their provider manual.  To keep up to date on the status of each state’s COVID flexibilities, see the COVID section of CCHP’s policy finder


Medicare Clarifies Interstate License Compact Pathways

In September the Centers for Medicare and Medicaid Services released a revised Medicare Learning Network (MLN) notice in order to clarify their policy for physicians and non-physician practitioners who get licenses through one of the various interstate licensing compacts and wish to bill Medicare Administrative Contracts (MACs) for services they provide.  CMS differentiates between the Interstate Medical Licensure Compact (IMLC), which requires physicians to go through a separate licensing process (though expedited) for each participating state, and some other non-physician practitioner (NPP) compacts that allow a provider to work in a compact member state, other than their home state, without going through the typical licensing process.  CMS states that for physicians and NPPS, they will treat licenses through the compacts as valid full licenses for purposes of meeting federal license requirements.  It instructs MACs to re-open any previously denied enrollment applications that resulted from a license compact issue. For more information, read the full MLN notice.


September Policy Developments in CCHP’s Telehealth Policy Finder and Policy Trends Maps

CCHP’s Policy Finder look-up tool and Policy Trend Maps were again updated in September based on the latest information from our ongoing state telehealth policy tracking. The latest states to be updated included Arizona, Massachusetts, Kentucky, Minnesota, Michigan, South Dakota, Texas, Wyoming, Wisconsin, Washington, and Virginia.

One of the most significant areas of policy change CCHP noted for this grouping of states were tightening of professional requirements around the use of telehealth by providers. For example, Michigan passed new consent requirements for podiatric medicine and surgery, social work, athletic trainers, massage therapists, acupuncturists and veterinary medicine.  Texas is another state that added practice standards (including a consent requirement and prescribing rules) for teledentistry specifically.  West Virginia adopted emergency telehealth practice standard regulations to implement a previous law that passed (WV Code 30-1-26(b)) for five professions, including dentistry, nursing, osteopathic medicine, social work and medicine.  The regulations require an in person visit every 12 months.  They also have consent and explicit prescribing requirements.  The regulations will sunset on August 1, 2027.

Most of the other state updates revolved around Medicaid, licensure compacts and professional regulation.  Some examples include:

  • Minnesota – Added audio-only coverage requirement for Medicaid and private payers through June 30, 2023 along with a study on the modality. Minnesota Medicaid also made permanent an allowance for schools enrolled in the Individualized Education Program to provide store and forward telemedicine when a child is distance learning at home for physical therapy, occupational therapy and speech language therapy services, and added a new telemonitoring section to their provider manual.
  • Michigan – Michigan Medicaid issued a new bulletin in August allowing for reimbursement of asynchronous telemedicine services, including store and forward, interprofessional telephone/internet/electronic health record consultations and remote patient monitoring services under certain circumstances.
  • Washington – Added that there is no prohibition against the consultation through telemedicine by a practitioner licensed by another state or territory in which he or she resides with a practitioner licensed in WA who has responsibility for the diagnosis and treatment of the patient within WA.
  • South Dakota- South Dakota Medicaid discontinued their coverage of telephonic and audio-only services that were being covered on a temporary basis during the emergency. They also removed their requirement that the distant site not be located in the same community as the originating site.
  • Kentucky – Added a new ‘telehealth glossary’ to provide standard definitions for all health care providers who deliver services via telehealth. The definition incorporates asynchronous store-and-forward telehealth, remote patient monitoring, audio-only telecommunications systems and clinical text chat technology into the definition of telehealth.
  • Texas – New law requires reimbursement for teledentistry by Medicaid and private payers. Texas also passed a second law requiring Medicaid cover certain types of services (such as preventive health and wellness services and case management) when delivered through telemedicine medical services, telehealth services or other telecommunications or information technology.  Finally, Medicaid is required to develop and implement a system for behavioral health services that will provide services to individuals through an audio-only platform.
  • West Virginia – New regulations allow for an out-of-state practitioner to practice in the state as an interstate telehealth practitioner as long as they go through a registration process.

Given the nuanced and varied approaches states are taking with their telehealth policies, please reference CCHP’s telehealth Policy Finder to link to additional details and access each states’ policies in their entirely.


Senators Issue Request for Information on Strategies to Improve Mental Health, Including Telehealth Solutions

Senators Ron Wyden (D-OR) and Mike Crapo (R-ID), chairman and ranking member of the Senate Finance Committee respectively, have teamed up in the issuance of a Request for Information (RFI) to better understand strategies that can help improve mental health and substance use disorder treatment.  Evidence-based solutions and ideas are sought in the areas of (1) strengthening the workforce; (2) increasing integration, coordination and access to care; (3) ensuring parity; (4) expanding telehealth; and (5) improving access for children and young people.  The Senators list specific questions under each category.  Questions related specifically to telehealth focus on the quality of care provided via telehealth, policy strategies that can be used to facilitate telehealth without exacerbating disparities, and lessons learned from the expanded use of telehealth during the COVID pandemic.  They ask for comments to be submitted to [email protected] by November 1, 2021.  For more information, read the full RFI.


RemoteICU Lawsuit Takes Aim at Medicare Overseas Provider Ban

Earlier this year, CCHP covered a federal lawsuit filed by telemedicine company RemoteICU (RICU) against the Centers for Medicare and Medicaid Services (CMS), alleging that the CMS restriction against reimbursing overseas telehealth providers violates federal telehealth waivers that mandate Medicare pay for critical-care services regardless of whether the provider and patient are in different locations. At the time, RICU cited an intensivist shortage and the potential for life and death situations if their employed overseas physicians can’t deliver critical care in hospitals.  While CMS does reimburse for critical-care services, they maintain that still doesn’t allow for Medicare coverage of services by overseas telehealth providers, even if they are licensed somewhere in the country.  As an update on the case, in August, the district court granted CMS’ motion to dismiss the lawsuit, stating that RICU failed to channel its reimbursement request through Medicare’s mandatory administrative claims process.  The court goes on to state that RICU’s motion for a preliminary injunction is dismissed because of lack of jurisdiction.  Healthcare IT News reports in an article on the matter, that in September RICU filed an appeal in response, and motion for expedited consideration.  CCHP has not been able to locate the appeal document.  Stay tuned for updates on the case.


Yes – Health Apps and Connected Devices must Notify Consumers when there is a Breach

The Federal Trade Commission (FTC) released a policy statement in September affirming that health apps and connected devices that collect health information must comply with the Health Breach Notification Rule and notify consumers and others when there is a health data breach. The rule seeks to provide data security for consumers from companies not covered by the Health Insurance Portability and Accountability Act (HIPAA).  It would apply to any company that is able to draw data from multiple sources, for example an app that collects health information from a consumer and also draws information through a synched fitness tracker.  This type of information can be sensitive and companies will now be subject to monetary penalties if they violate the rule.  The statement emphasizes that a breach isn’t limited to cybersecurity incidents, but could also result from unauthorized access.  For more information, read the FTC statement in its entirety as well as their press release on the topic.


Utilization of Patient Portals is Up, even Pre-Pandemic, ONC Survey Finds

Last month the Office of the National Coordinator (ONC) for Health IT released a data brief focused on individual’s access to patient portals and use of health apps. The Health Information National Trends Survey (HINTS), which collects data on the American public’s knowledge, attitudes and use of health-related information, was the primary data source for the report. Surveys were conducted between January and April 2020, and thus the findings largely represent pre-pandemic insights.  Some of the findings highlighted in the report include:

  • Six in ten individuals were offered a patient portal in 2020 and 40% accessed their record at least once.
  • Four in ten accessed the patient portal through a health app in 2020.
  • Encouragement to use the health app by their providers plays a significant role in determining if individuals will actually do so.
  • A third of individuals have downloaded their medical record using a patient portal in 2020. This number has nearly doubled since 2017.

The growth of patient portals in many ways has grown alongside telehealth, as many patient portals integrate telehealth tools within their platforms. Although this particular data brief did not address telehealth directly, it did find that six in ten patient portal users exchanged secure messages with their health care providers in 2020, a practice that is sometimes included in policy definitions of telehealth.  To learn more about the findings in the ONC data brief, read their Overview Article, or the brief in its entirety.


Physician Fee Schedule Comments

The comment period for the proposed 2022 Medicare Physician Fee Schedule closed on September 13, 2021.  The proposed fee schedule offered the possibility of major changes to permanent Medicare reimbursement policy for telehealth.  Mainly, the addition of audio-only for the delivery of mental health services in limited circumstances and a new definition of a “mental health visit” to allow federally qualified health centers (FQHCs) and rural health centers (RHCs) to deliver mental health services via “interactive, real-time telecommunications technology” including the audio-only modality. The services CMS placed into their Category 3 in last year’s PFS are also now proposed to remain available until the end of 2023. See CCHP’s factsheet for more details and a full summary of proposed policy changes.

Over 35,000 comments were received in response to the proposal, with 74% of those comments addressing the telehealth proposals.  CCHP was of course among the commenters, along with a plethora of other entities, such as hospitals, physician groups, individuals and advocacy organizations. One letter in particular stands out because it was written by 21 organizations, including the American Psychiatry Association, National Association of Rural Health and a variety of other organizations and health systems mutually interested in ensuring FQHCs, RHCs and CAHs are able to continue delivering behavioral health services to rural communities even once the COVID emergency ends. It asks CMS to leverage telehealth to meet the increased needs of the safety net. Other organizations, such as the American Medical Association had more concrete requests for CMS in their letter, including allowing all the codes reimbursed during the COVID-19 pandemic to continue until 2023, including telephone evaluation and management services (99441-99443).  It is important to note that some telehealth restrictions in permanent telehealth policy (such as the geographic and originating site restrictions for non-mental health services) are in federal law, and CMS is not able to alter the policy without passage of a new law that would give them more flexibility.

To access all the comments, search the database.  Additional items and details about the CY 2022 PFS can be found in CCHP’s fact sheet, explainer video, and slide deck. CMS typically finalizes their fee schedule in late November or early December.



Protecting Rural Telehealth Access Act

HR 5425 (McKinley R-WV) – Eliminates the geographic restriction for telehealth Medicare reimbursement and allows the home to be an eligible originating site. The bill would also add certain flexibilities for critical access hospitals, including allowing any qualified provider to deliver a behavioral health service and any other outpatient critical access hospital service to be delivered to an eligible telehealth individual.  See bill language for definition of a qualified provider.  The payment amount must be equal to 101 percent of the reasonable costs of the hospital in providing such services, unless the hospital makes an election to be paid based on alternative methodology described in statute.  The bill also requires FQHCs and RHCs be reimbursed for telehealth delivered services at a payment rate determined by the Secretary.  Finally, the bill clarifies that in Federal Regulation, the term ‘telecommunications system’ includes, in the case of furnishing specified telehealth services, a communications system that uses audio-only technology.  See bill language for definitions of eligible telehealth services and qualified providers.  (Status: 9/29/21 – Introduced)

National Defense Authorization Act for Fiscal Year 2022

HR 4350 (Rogers R-AL)  – Stipulates that during a health emergency: (1) the TRICARE program may not charge a cost sharing amount for telehealth services; (2) telehealth appointments that involve audio communication are considered to be telehealth appointments; (3) Reimbursement can be made under the TRICARE program regardless of whether the provider is licensed in the state the covered beneficiary is located. This would also apply to providers overseas as long as they are licensed to practice in an equivalent capacity by their respective foreign government.  (Status: 9/24/21 – Passed House)

Women’s Health Protection Act of 2021

HR 3755 (Allred D-TX)  – States that a health care provider has a right to provide an abortion without limitations or requirements, including a limitation to provide abortion services via telemedicine other than a limitation generally applicable to the provision of medical services via telemedicine. (Status: 9/29/21 – Read the Second Time. Placed on Senate Legislative Calendar under General Orders.)

Temporary Responders for Immediate Aid in Grave Emergencies (TRIAGE) Act of 2021

HR 5248 (Crow R-FL) – Creates a Provider Bridge Program to streamline the process for mobilizing healthcare professionals during COVID-19 and to help connect health care professionals by means of telehealth, among other elements. (Status: 9/14/21 – Introduced and referred to House Committee on Energy and Commerce)

Making Advances in Mammography and Medical Options for Veterans Act

HR 4794 (Miller-Meeks R-IA) – Requires the Secretary of Veterans Affairs to carry out a pilot program to provide telemammography services for veterans who live in states without a Department of Veterans Affairs breast imaging services facility, or areas where access to such a facility is difficult or not feasible.  The Secretary may use community-based outpatient clinics, mobile mammography, federally qualifies health centers, rural health clinics, critical access hospitals, clinics of the Indian Health Services and other sites as needed. (Status: 9/9/21 – Referred to House Subcommittee on Health)




SB 312 – Removes the exclusion of audio-only telephone calls from the definition of the term ‘telehealth’ in law.  Narrows the prohibition on prescribing controlled substances through telehealth to only include controlled substances listed in Schedule II in a particular statute of Florida law. Previously all controlled substances were restricted from being prescribed via telehealth with a few exceptions. (Status: 9/22/21 – Filed)


HB 602 – Excludes audio-only telephone from the definition of telemedicine and removes coverage and reimbursement parity language from existing law. Also changes language to state that health plans shall allow for compensation of a distant site and originating site no greater than the total amount allowed for in-person services. (Status: 9/8/21 – Subcommittee work session scheduled for 10/6/21)


  1. 4205 – Enters New Jersey into the Psychology Interjurisdictional Compact. (Status: 9/24/21 – Approved).


HB 76 – Establishes a pilot project to provide emergency medical services instruction and emergency prehospital care instruction through a telemedicine medical services or telehealth service provided by regional trauma resource centers to providers in rural area trauma facilities and emergency medical service providers in rural areas.  See legislation for additional details. (Status: 9/16/21 – Filed)



Digital literacy: Overcoming isolation in a connected world

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Source: SCETV

When the Covid-19 Pandemic hit, many people became isolated; but technology offered a way to stay connected. However, for many seniors, new technology is like a foreign language.

“If you don’t learn technology, you’re gonna be left behind and a lot of folks are left behind now,” said Paul Dukes, a senior living in Columbia.

Dukes enrolled in a digital literacy class offered by Palmetto Care Connections, a nonprofit telehealth network that works to connect healthcare providers to patients in rural communities through telehealth.

Funded by the Rural Local Initiatives Support Corporation, and the South Carolina Department on Aging through the CARES Act, the digital inclusion program gives 100 tablets to seniors across five counties: Allendale, Barnwell, Clarendon, Lower Richland and Williamsburg. The program provides the seniors with internet service and digital skills training.

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Senators, FCC Official Parse Ties Between Telehealth, Affordable Broadband

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Source:  MeriTalk
By: Lisbeth Perez

Senators and healthcare IT experts raised concerns this week that many in the United States cannot benefit from the recent boom in telehealth services because of a lack of affordable high-speed internet access across the country.

The COVID-19 pandemic has changed so much about how people live their lives, but nothing changed so fundamentally as the interaction between doctors and their patients. The number of telehealth appointments is now twenty-three times higher than it was before the pandemic. That’s also been the case on the Federal government front, with the Department of Veterans Affairs reporting a 12-fold surge in telehealth visits between February and May 2020, to 120,000 per week.

“These programs are essential, but our work is just beginning,” said Sen. Ben Ray Luján, D-N.M., at an October 7 Senate Commerce, Science, and Transportation Committee hearing that focused on telehealth capabilities.

“The digital divide is standing in our way of connecting all Americans to this vital service,” the senator said.

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FCC Preparing to Announce Next Batch of Connected Care Pilot Program Awards

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By Eric Wicklund

The agency, which unveiled the latest recipients for COVID-19 Telehealth Program awards last week, is looking to announce the third group of telehealth projects qualifying for Connected Care Pilot Program funding later this month.

– The Federal Communications Commission is getting ready to unveil the next round of healthcare organizations that will receive funding through the Connected Care Pilot Program for telehealth projects.

The FCC is scheduled to consider at its October 26 open meeting a Public Notice announcing the third round of selections for the $100 million program, which is designed to help projects “defray the costs of providing certain telehealth services for eligible health care providers, with a particular emphasis on providing connected care services to low-income and veteran patients.”

In particular, the agency says these projects “will address treatments for maternal health/high-risk pregnancy, COVID19, other infectious diseases, opioid dependency, mental health conditions, and chronic or recurring conditions.”

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Palmetto Care Connections Names Director of Digital Literacy Programs

By News

BAMBERG, SC—Palmetto Care Connections (PCC) Chief Executive Officer Kathy Schwarting announces that Diane Springs Washington, MBA, PMP has joined PCC as director of digital literacy programs.

In her role, Washington is responsible for providing strategic leadership and operational oversight for PCC’s digital literacy programs. Her responsibilities include digital literacy program and curriculum development; supervising instructional and professional staff; assisting in connecting seniors and underserved citizens with broadband resources; overseeing PCC’s computer and device refurbishment program; and developing, securing and implementing state, federal and private digital literacy program grants.

“COVID-19 has created an explosion in telehealth services and uncovered a tremendous need for internet access and digital literacy in rural areas,” said Schwarting. “As Palmetto Care Connections surveyed rural health care providers, we confirmed that many of the seniors they serve have difficulty using and understanding technology, and many do not have internet access at home. The goal is to connect seniors not only to telehealth, but also to a variety of quality-of-life resources to combat the social isolation that many seniors have faced during the pandemic.”

“Palmetto Care Connections recently completed Digital Literacy training for seniors aged 60 and older in the rural communities of Blackville, Allendale and the Lower Richland region as part of a pilot program in five S.C. counties. The pilot program has already proven to be very successful, and we anticipate growing the digital literacy training statewide for both seniors as well as underserved populations who need digital skills to apply for jobs and enhance daily living. Diane has a wealth of experience in information technology project management and we are very pleased that she has agreed to lead the PCC digital literacy programs.”

Washington’s career experience includes more than 27 years at Prisma Health in Columbia, S.C. serving as IT program manager, IT strategic programs manager, IT senior project manager and IT systems analyst. Previous experience includes data center systems coordinator of The Riverside Church of the City of New York, system support analyst of United Way of Tri-State, New York, and system specialist of Human Resources Planning Society, New York.

Washington received a Master of Business Administration degree in Health Services Administration from Strayer University in Columbia, S.C. and a Bachelor of Business Administration degree in Computer Systems from Baruch College in New York, N.Y. She completed the Mastering Project Management Certificate program at Villanova University in Villanova, Pa., and is certified as a Project Management Professional (PMP) by the Project Management Institute.

Washington is a member of the Project Management Institute, Midlands Chapter, Columbia, S.C. and has served in volunteer and leadership roles.  She is an officer and board member of the Center for Community and Family Transitions in Columbia, S.C. She was a member of Palmetto Health Toastmasters and has served in the roles of president, vice president of marketing, vice president of public relations, and club coach/mentor.

Established in 2010, PCC is a non-profit organization that provides technology, broadband, and telehealth support services to health care providers in rural and underserved areas in S.C. PCC leads the S.C. health care broadband consortium which facilitates broadband connections for health care providers throughout the state. PCC co-chairs the South Carolina Telehealth Alliance, along with the Medical University of South Carolina, partnering with health care organizations and providers to improve health care access and delivery for all South Carolinians. PCC received the National Cooperative of Health Network Association’s 2021 Outstanding Health Network of the Year award.