Welcome back to another edition of Fabric Regulatory Roundup! For this month, let’s look at where the latest telehealth regulations are and what’s been happening this past month.
Federal
US House bill 6400 – Save America’s Rural Hospitals Act
A bipartisan bill aimed at rescuing rural hospitals on the brink of bankruptcy. This would be accomplished by:
- Eliminating Medicare sequestration for rural hospitals
- Making Medicare telehealth service enhancements permanent for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs)
- Extending increased Medicare payments for rural ground ambulance services currently set to expire December 31, 2022
- Extending Medicaid primary care payments
- Reinstating hold harmless treatment for hospital outpatient services for sole community hospitals (SCHs)
- Reversing cuts to reimbursement of bad debt for critical access hospitals (CAHs) and rural hospitals
Provider Relief Fund – Phase 4 Distribution
The Department of Health and Human Services (HHS) has released $2 Billion in Provider Relief Fund Payments to health care providers impacted by the COVID-19 Pandemic. This amounts to nearly $11 billion in relief funds distributed to more than 74,000 providers in Phase 4.
- Provider Specific Distribution
- General Distribution by State
- American Rescue Plan Rural Payments by State
By State
Arizona House Bill 2374 – Introduced 01.13.22
Related to the department of health’s Acute Care at Home Pilot Program, this bill would allow health care services provided by or under the direction of the hospital to be delivered by “Mobile Health Practitioners”. Mobile health practitioners would work under the supervision and delegation of a physician and provide services outlined in the supervision agreement. A mobile health practitioner must have at least two years’ experience as a paramedic and is certified in community paramedicine.
Hawaii Senate Bill 2073 – Introduced 01.19.22
To ensure telehealth access to those in underserved and low-income communities where residents may lack broadband or cellular data plans, this bill would remove the current restriction on use of standard telephone contact. Standard telephone contact for telehealth is noted to be endorsed by the Hawaii primary care association.
Kentucky – State of Emergency Extended to April 14, 2022
The General Assembly has approved and extended the PHE with some modifications. Included in the extension is the Department of Insurance Order, dated March 18, 2020, related to telehealth remote communications and the prior relationship requirement. Orders were extended approving multiple licensure boards to extend the use of telehealth including but not limited to diabetes educators, licensed professional counselors, occupational therapists, alcohol, and drug counselors.
Mississippi – House Bill 966 & Senate bill 2857 introduced
These companion bills would expand Medicaid eligibility by allowing Federally Qualified Health Clinics (FQHCs) and Rural Health Clinics (RHC) to serve as both originating and distant sites in the provision of telehealth services.
Maryland – House Bill 421 Introduce 01.19.22
To combat behavioral health provider shortages, this bill would create a permanent structure to allow out-of-state practitioners to provide behavioral health services via telehealth. These providers would be required to hold a current, valid, and unrestricted license in another state, district, or territory of the US. They would be required to follow all state guidelines and standards of practice.
Missouri – House Bill 2510 Introduced 01.20.22
This bill would allow health care providers fully licensed in another state, US territory, or District of Columbia to treat patients in Missouri. Out-of-state providers would be subject to the regulations of their professional board. For this bill, the term “health care provider” includes any health care professional licensed in another state, US territory, or the District of Columbia.
Oregon – House Bill 4034 Prefiled 01.25.22
This bill would redefine telemedicine to mean “the provision of health services to patients by physicians and health care practitioners from a distance using synchronous or asynchronous electronic communications.” It would also allow physicians and physician assistants to use telemedicine and prevent the medical board from establishing standards that are more restrictive than in-person care.
Virginia – House Bill 921 Introduced 01.12.22
This bill would allow the prescription of certain controlled substances without an in-person visit via asynchronous or synchronous interaction. Asynchronous interaction in the bill means “an exchange of information between a patient and a prescriber that does not occur in real time.” Asynchronous interaction is noted to be a viable method to establish a bona fide practitioner-patient relationship for the purpose of evaluation and prescribing of Schedule V controlled substances. A synchronous interaction would be required for the purpose of evaluation and prescribing of Schedule II-IV controlled substances.
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