eHI joined more than 70 organizations in urging Congress to extend the policy changes that allowed 35 million Americans with high-deductible health plans coupled with Health Savings Accounts (HDHP-HSAs) to receive telehealth benefits from their employer or insurer pre-deductible. If Congress does not act, these flexibilities will expire at the end of the year.

eHI joined other digital health associations in sending a letter to Senate Appropriators in support of increased funding for Telehealth Resource Centers, which have been level-funded since 2006 despite an exponential growth in the use of telehealth. You can find a copy of the letter here.

On Monday, eHI submitted a comment letter in response to the Calendar Year 2022 Medicare Physician Fee Schedule proposed rule. The letter includes comments on proposals related to telehealth reimbursement, remote therapeutic monitoring, and the Promoting Interoperability Program. 

On Tuesday, July 13, the Center for Medicare & Medicaid Services (CMS) released a proposed rule that when finalized, will set Medicare Part B reimbursement policies for next calendar year. Most notably for eHI members, CMS includes proposals to implement provisions of the Consolidated Appropriations Act of 2021 that expanded reimbursement for telemental health services, reimburse for new remote therapeutic monitoring codes, and postpone the compliance date for electronic prescribing of controlled substances, among other proposed changes. Download an eHI-prepared summary of the health IT-related proposed changes below.

On June 28^th, eHI submitted a comment letter in response to the Fiscal Year 2022 Medicare Hospital Inpatient Prospective Payment System proposed rule. The Centers for Medicare & Medicaid Services (CMS) have proposed a number of changes to the Promoting Interoperability Program, on which eHI provided comment. 

eHI was joined by several hundred HIPAA-aficionados on Wednesday for our second “HIPAA for Dummies” webinar, during which we covered numerous hot topics – as dictated by our certainly NOT dumb attendees. Starting with what in the heck HIPAA stands for and wrapping up with an overview of the interplay between HIPAA, Europe’s GDRP, and new state data privacy laws in California and Virginia, in between we traveled through the land of permitted unauthorized disclosures, what happens to your health data (from a legal perspective) when it leaves the traditional health care system (ie: is sent from your doctor to your phone), and how COVID and vaccines relate to HIPAA obligations and protections.

In January of this year, the Department of Health & Human Services Office of Civil Rights released the first major proposed changes to the Health Insurance Portability and Accountability Act (HIPAA) since passage of the American Recovery and Reinvestment Act in 2009. The proposed changes, if finalized, would update rules regarding disclosure of personal health information (PHI) and rights of individuals to access their PHI. If you are interested in learning more about the proposed changes, you can find a recording of and slides from eHI’s April Monthly Policy Briefing with eHI’s Senior Vice President & Counsel Alice Leiter on the topic here.

On Thursday, eHI submitted a comment letter in response to the Notice of Proposed Rulemaking, which you can find here. For more information on eHI’s privacy work, please reach out to Alice.

During the COVID-19 pandemic there was a sharp increase in the use of telehealth – a 1,000 percent increase in March 2020 and a 4,000 percent increase in April 2020.  Even more extreme, telehealth utilization among Medicare beneficiaries increased 13,000 percent in just a month and a half. This was largely due to federal and state governments relaxing decades-old laws and regulations. However, many of these laws and regulations were only temporarily changed – meaning that at the end of the COVID-19 public health emergency (PHE) period, the restrictions will go back into effect unless legislators enact permanent changes.

Thankfully, there is widespread agreement among stakeholders and legislators that we cannot go back to how it was before, but agreeing on exactly what permanent policies should look like is proving difficult. This week, the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021 was reintroduced in the Senate and in the House. The Senate Working Group members Senators Brian Schatz (D-HI), Roger Wicker (R-MS), Ben Cardin (D-MD), John Thune (R-SD), Mark Warner (D-VA), and Cindy Hyde-Smith (R-MS) introduced the legislation along with 50 of their colleagues in the Senate. Identical legislation was introduced in the House by Telehealth Caucus members Representatives Mike Thompson (D-CA), Peter Welch (D-VT), David Schweikert (R-AZ), Bill Johnson (R-OH), and Doris Matsui (D-CA). The legislation is supported by more than 150 stakeholder organizations, including eHI.

While the CONNECT for Health Act led the way as landmark comprehensive telehealth reform legislation beginning in the 114^th Congress, it is certainly not the only legislative approach to ensuring telehealth reimbursement post-COVID. Others include the Telehealth Modernization Act of 2021 (HR 1332/S 368), the Protecting Access to Post-COVID-19 Telehealth Act of 2021 (HR 366). At the crux of the debate around permanently removing restrictions on Medicare reimbursement of telehealth services are questions around controlling for overutilization of unnecessary services and protecting both the Medicare program and beneficiaries from potential fraud and abuse. These were common lines of questioning from members of the House Ways & Means Health Subcommittee, which held a hearing this week entitled Charting the Path Forward on Telehealth (find the full hearing recording here and an eHI-prepared summary here). In his opening statement, Subcommittee Chairman Lloyd Doggett (D-TX) stated his intention to introduce legislation that would enact recent recommendations from MedPAC, which calls for a temporary extension of current statutory and regulatory flexibilities while data is collected and analyzed to help inform permanent policies. In order to combat fraud and abuse, MedPAC recommended requiring in-person appointments prior to ordering high-cost durable medical equipment (DME) and lab tests. This is meant to target areas of concern outlined by OIG whereby “telefraud schemes” are used to fraudulently prescribe DME and high-cost lab tests like genetic tests. OIG clarified that in many cases, the telefraud perpetrators do not bill for the telehealth service. Ensuring program integrity and protecting patients is essential; however, we should not let the potential bad actions of a few prevent all from benefiting from what has proven to be a lifeline during the pandemic. Any legislation addressing Medicare reimbursement for telehealth services should not replace the existing arbitrary restrictions on telehealth with different arbitrary restrictions like prior in-person visit requirements. 

All of this to say: we don’t know exactly what lies ahead for any of these telehealth bills, but we do know that never before has telehealth policy been at the forefront of so many healthcare discussions in D.C., and it’s certainly not a matter of if but of when. eHI and our members will continue to be a part of these on-going debates and provide updates and engagement opportunities. If you have any questions in the meantime, feel free to reach out to me at catherine@ehidc.org.

The new administration brought in new leadership at the Department of Health & Human Services, including at the Office of the National Coordinator for Health IT (ONC). In January, Dr. Micky Tripathi was named the new National Coordinator for Health IT, replacing Dr. Donald Rucker. Dr. Tripathi assumed his new role at a critical time for ONC as of April 5th, provisions of ONC’s information blocking regulations went into effect, not to mention the important role of health IT in combatting the COVID-19 pandemic.

On Tuesday, eHI staff and members of the Policy Steering Committee met with Dr. Tripathi and his team at ONC to discuss eHI’s policy principles and priorities, learn more about ONC’s ongoing work to advance interoperability, and identify areas for collaboration moving forward. ONC staff provided updates on work critical to many eHI members, including patient matching, the Trusted Exchange Framework and Common Agreement (TEFCA), and public health systems modernization. eHI looks forward to continuing to engage with ONC on our shared priorities. 

On April 1, eHI joined more than 100 other organizations in urging Congressional Appropriators to remove language in Section 510 of the Fiscal Year 2022 Labor, Health and Human Services, and Education and Related Agencies (Labor-HHS) Appropriations bill that prohibits the US Department of Health and Human Services (HHS) from spending any federal dollars to promulgate or adopt a national unique health identifier standard. This antiquated ban has stymied federal patient matching efforts for decades and we urge removing the ban once and for all.