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Monthly Archives

March 2022

Telehealth Cut Missed Appointments Among Kids With TB by 11%

By News


By Mark Melchionna

The implementation of telehealth had a significant impact on missed follow-up appointments among pediatric patients with tuberculosis infections (TBI), reducing the rate of missed visits by 11.1 percent, a study published in the journal Tropical Medicine and Infectious Disease showed.

TB infections occur in about a quarter of people globally. Although the percentage of individuals with TBI who develop an active case of the infection is much lower at 5 to 15 percent, some factors limit treatment, specifically for pediatric patients.

The study subjects received care at the Yale Pediatric Winchester Chest Tuberculosis Clinic and were younger than 18 years. The data collected for the study related to demographics and the number of missed appointments and therapy completions by each patient.

During the study period, the expansion of the clinic and the COVID-19 pandemic led to telehealth implementation for follow-up visits. Researchers evaluated the effect of telehealth on the clinic one year later.

Before implementing telehealth, 16.9 percent of TBI patients missed appointments between 2016 and 2019.

In 2021, after telehealth services were implemented, 54.2 percent of follow-up TBI visits took place virtually. The missed follow-up appointment rate for children with TBI declined from 16.9 percent to 5.8 percent.

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Expect Telehealth Rule Changes to Stay in Place — At Least for a While

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by Joyce Frieden, Washington Editor, MedPage Today

— Congress already extended the changes for 5 months and likely will extend them again, expert says

Telehealth rules that have been loosened during the COVID-19 pandemic will likely be extended temporarily before any permanent changes are made, one expert said at a briefing sponsored by the Kaiser Family Foundation.

The public health emergency necessitated by the pandemic itself has been extended through mid-April. In addition, Congress has already extended the telehealth flexibilities for 151 days, or about 5 months, beyond that, explained Krista Drobac, executive director of the Alliance for Connected Care, a lobbying group for telehealth providers. That extension was needed to match up with a temporary increase in Medicaid reimbursement for U.S. territories, she said at the Tuesday event.

Congress also required the Medicare Payment Advisory Commission (MedPAC) and the Office of Inspector General (OIG) at the Department of Health and Human Services to report on how well the telehealth flexibilities are working, but those reports aren’t due until June 2023, Drobac said. “I do not believe that Congress will make permanent changes to the law without real analysis by MedPAC or OIG, so our expectation is that the next action … will be another extension. And then once those reports come out, and more peer-reviewed analysis comes out of what happened during the pandemic, then we’ll lobby on permanent changes.”

Telehealth flexibilities for the Medicare program that have been in place during the pandemic include:

  • Fewer restrictions on where telehealth could be provided — previously Medicare would only reimburse for telehealth services provided to rural beneficiaries, and the beneficiary had to go to a medical facility to receive the service; those rules were relaxed during the pandemic. As a result, in 2020, “we had 28 million [telehealth] visits by Medicare beneficiaries; that compares to less than 350,000 visits in 2019,” said Drobac.
  • More Medicare provider types were able to use telehealth, including speech therapists, occupational therapists, and physical therapists.
  • The Drug Enforcement Administration loosened its restrictions on medication prescribing via telehealth, including requiring an in-person visit prior to prescribing controlled substances — a change that affected mostly behavioral health patients, she said.
  • Medicare allowed audio-only telehealth to be reimbursed.

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Telehealth Policy Update

By News

Source: The National Law Review

There have been several significant developments with regard to Federal government telehealth policy. These include the recently enacted appropriations bill funding the Federal government for the balance of the fiscal year, a Department of Health and Human Services Office of Inspector General data brief, the MedPAC annual report to Congress and statements by the Secretary of Health and Human Services.

Appropriations Law

On March 15, 2022, President Biden signed H.R. 2471, the “Consolidated Appropriations Act, 2022” [Public Law 117-103].  The new law authorizes the Telehealth Network Grant Program at the Health Resources and Services Administration (HRSA) to include providers of prenatal, labor care, birthing, and postpartum care services.

  • H.R. 2471 contains provisions dealing with telehealth flexibility extensions.
  • Removes geographic requirements and expands origination sites for telehealth services.
  • Expands practitioners eligible to furnish telehealth services.
  • Extends telehealth services for Federally Qualified Health Centers and rural health clinics.
  • Delays the in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology.
  • Allows for furnishing of audio-only telehealth services.
  • Use of telehealth to conduct face-to-face encounter prior to recertification of eligibility for hospice care during the PHE.
  • Extends the flexibility allowing a high deductible health plan to cover telehealth benefit (for months beginning after March 31, 2022, through the end of 2022) pre-deductible and still qualify as a HDHP with a Health Savings Account.

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Telehealth PHE Expansions to Continue 151 Days Post-PHE and New MedPAC Report Recommendations

By News

Source: Center for Connected Health Policy

On March 15th President Biden signed the Consolidated Appropriations Act of 2022.  This bill will extend federal telehealth flexibilities for 151 days post-public health emergency (PHE), including PHE location, provider, and audio-only expansions, and includes new report requirements. A delay to the new in-person telemental health visit requirement in Medicare was also included for the same period of time.

The telehealth components in the legislation include:

  • Telehealth Flexibility Location – Geographic & rural exceptions to allow for any site including the home to continue for 151 days after the PHE ends – no facility fee for these sites
  • Telehealth Flexibility Provider Type – Adds occupational therapists, physical therapists, speech-language pathologists, audiologists, and federally qualified health centers (FQHCs) and rural health clinics (RHCs) to eligible provider list for 151 days
  • Audio-Only – Continue to allow for the 151-day extension period
  • In-person visit requirement for telemental health – Delay requirement until after the 151 days extension
  • Use of telehealth for recertification of eligibility for hospice care – Continue to allow for the 151-day extension period
  • New Reports
    • MedPAC report due June 15, 2023 to Congress, includes looking at payment policy for telehealth for FQHC and RHC’s
    • Beginning July 1, 2022, Secretary of Health and Human Services must publicly publish on quarterly basis data on Medicare claims on telehealth services including utilization and beneficiary characteristics
    • By June 15, 2023, Office of Inspector General to submit to Congress fraud, waste, and abuse report on program integrity

Funding opportunities that could be put toward telehealth are also included in the legislation, including funding for rural hospital programs and telehealth networks, in addition to grants that will establish or sustain mobile teams or enhance access through telehealth.

While the resources and extensions in the agreement are promising, they signify that conversation around permanent telehealth policies are far from over. For more information, please review the Consolidated Appropriations Act of 2022 in its entirety. For a helpful breakdown of the bill and its telehealth components, access CCHP’s Consolidated Appropriations Act of 2022 Chart.


MedPAC Report Recommendations Related to Telehealth Data

Last week the Medicare Payment Advisory Commission (MedPAC) released its March 2022 Report to Congress: Medicare Payment Policy. The report covers a variety of Medicare payment issues and recommendations, including suggestions related to gathering more information regarding the delivery of care via telehealth from providers. In particular, MedPAC recommends the Centers for Medicare & Medicaid Services (CMS) require clinicians to use an audio-only claims modifier in order to track modality specific information, and that home health agencies (HHAs) and hospice providers be required to report the provision of telehealth on Medicare claims. The rationale behind the recommendations is that more data is needed to truly understand the impact of telehealth on quality, cost, and access to determine the accuracy of payments. The amount of time necessary and sufficient to collect and complete such evaluations is unaddressed in the report. As the federal government postpones permanent policy changes in exchange for limited extensions, it is important that policymakers consider the time it will take to effectively assess the delivery of care via telehealth using additional data.

The main telehealth issues of focus within the MedPAC report include that currently, there is a lack of consistency restricting the ability to track audio-only and telehealth visits by certain providers. For instance, some telehealth expansions have been made permanent for HHAs, which MedPAC suggests significantly expanded their telehealth programs during the pandemic. While the HHAs were supposed to report the costs of telehealth services on their Medicare cost report, there was no requirement to report any other information about telehealth use related to frequency, duration, modality, or which beneficiaries received such services. The same limited information applies to hospice providers.  MedPAC offered that operationalization of this data reporting component could be achieved through the use of a claims modifier as long as CMS permits the use of telehealth services in the hospice setting.

Other telehealth findings provided in the report include:

  • Beneficiaries’ access to care is comparable to privately insured individuals and that during the past year, half of beneficiaries accessed clinicians via telehealth
  • Nearly half of Medicare beneficiaries used telehealth at least once in the past year
  • Audio-only telephone visits were most common – 37% of elderly Medicare beneficiaries used audio-only
  • Interactive video visits were used by 23% of Medicare beneficiaries
  • 86% of beneficiaries were satisfied with their telehealth visits and around half wanted to continue using telehealth post-pandemic

MedPAC states that their recommendations related to telehealth data collection should apply regardless of whether Medicare covers these services temporarily or permanently. However, it will be difficult to collect helpful data on telehealth without maintaining coverage and access for telehealth. As MedPAC notes, without more information their ability to understand the role that telehealth has played during the public health emergency (PHE) is limited, as is the ability of policymakers in determining post-PHE policy changes. The report also reiterates a policy option they provided to Congress in their March 2021 report, in which they suggested CMS continue to cover telehealth after the PHE for a “limited period” such as one to two years after the PHE ends to allow for gathering of additional evidence on the impact of telehealth to determine permanent telehealth payment policies. Meanwhile, President Biden signed the Consolidated Appropriations Act of 2022 last week which extended telehealth expansions for just five months after the end of the PHE, raising questions related to how that timeline was determined and if it will be sufficient to address remaining concerns and questions related to long-term telehealth policies.

Please review the MedPAC report for additional details on their findings and recommendations.

6 tips to succeed with telehealth in allergy and immunology care

By News

Source: AMA

By:  Tanya Albert Henry

With only about 3,000 allergists and immunologists nationwide, telehealth has the potential to be a potent tool to help more patients get the specialized care they need and get it sooner.

By putting telehealth to its best use, allergists and immunologists can improve access to care, make monitoring an ongoing diagnosis easier for the patient, and help primary care physicians treat patients whose needs may not require subspecialty treatment.

During an AMA Telehealth Immersion Program webinar co-hosted with the American College of Allergy, Asthma & Immunology, experts showcased how allergists and immunologists are leveraging the technology to provide high-quality care.

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Spartanburg County to expand broadband access in rural areas

By News

Source: Channel 7 WSPA

SPARTANBURG COUNTY, S.C. (WSPA) – Internet access may improve soon in rural areas of Spartanburg County. The County Council voted Monday to spend $4 million in American Rescue Plan funding to expand broadband access in rural areas.

“We learned, during the pandemic, how lacking we were in broadband when you get outside the municipalities,” said Councilman David Britt.

The county will now select a broadband carrier to work with, which will put up an additional $10 million to make this project happen. The carrier will then survey the areas and decide how to install the technology.

“This infrastructure is almost comparative to electricity in the 1920s,” said Councilman Justin McCorkle.

“There are lot of people spending a lot of time at home who need this service that we don’t provide in these rural areas, and they can’t afford to do it,” added Councilman Bob Walker.

The county estimates this project will provide internet access to more than 3,500 homes.

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S.C. Rep. Williams seeking $59.1 million in funding for Hampton, Jasper counties

By News

Source:  Bluffton Today

By:  Michael M. DeWitt, Jr.

From recreation to education, from community centers to international commerce hubs, South Carolina Representative Shedron Williams is seeking millions in state funding for the people he represents in Hampton and Jasper counties.

 Ahead of the S.C. House of Representatives debate on the state budget later this month, Rep. Williams (D-Hampton) has made several budget requests totaling more than $59.1 million. The largest of those request include a $37 million investment in facilities in the newly consolidated Hampton County School District and $7 million for the Jasper port.

“With the influx of federal funds coming to our state on top of a surplus, this year’s budget presents an opportunity to make historic investments in education and other neglected projects in our state,” Williams said.

“All I can do is ask and be at the table,” Williams stated in an email to The Hampton County Guardian, but added that “We are expecting the majority of the items.”

While Williams priorities include a countywide recreation/health and wellness center in Hampton County as well as improvements to Lake Warren State Park, here is a full breakdown of all of Williams’ requests:

Southern Carolina Alliance

$700,000 for a rail crossing at the Southern Carolina Industrial Park. This item is a must for the full development of the new agribusiness that is promising 1,500 jobs, said Williams.

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Virtual Conferences Allow Earlier Detection of Disease for Lung Cancer Patients

By News

Source:  SC ETV

By:  Colin McCawley and Joy Bonala


“We don’t want to overburden the patient saying that every nodule is a cancer, at the same time the cases which are cancer, time is important and it takes a lot of money, effort and physicians to manage those cancers,” Dr. Jona said.

Using telehealth, patients can connect to the Lung Nodule Clinic through a video call. Before the use of this telehealth clinic, patients waited more than three months for a care plan. That’s because scheduling a visit with each specialist took time. But now all the specialists are brought together and patients receive a care plan within one week.

“The good thing about this is instead of the patient going to all the different clinics, it is one stop and they have a plan,” Dr. Jona said.

This new system is a “game-changer,” according to Dr. Jona. In addition to cutting down on travel time, using telehealth also allows more family members to join the video call and connect to the clinic.

“The whole family can participate in this,” Dr. Jona said. “This is prime time; they can see what’s really going on and that has helped the patients and the family understand exactly what is going on.”