Telehealth extensions signed into US law with Federal FY 2023 omnibus bill

Jammed into the final moments of the now-ended 117th Congress before Christmas was the passage of the FY2023 ‘omnibus’ $1.7 trillion Federal budget bill. This bill did at least several good things for those of us concerned with US telehealth, as it extended provisions for Medicare reimbursement that become guidelines for commercial health plans and help to cement telehealth as a permanent part of health care delivery. There is also a tax provision that affects high-deductible health plans. 

Their passage is important as the Covid-19 Public Health Emergency (PHE) is set to expire on 11 January and no movement has been publicly discerned for its renewal. In the fall, the Department of Health and Human Services (HHS) notified US state governors that there would be at least a 60-day notice before the PHE ends. It is unknown whether this notice has been given.

To summarize the two-year extensions that go to the end of 2024:

  • Expanding originating and geographic site to include anywhere the patient is located, including the patient’s home
  • Expanding eligible practitioners qualified to furnish telehealth services, including occupational therapists, physical therapists, speech-language pathologists, and audiologists
  • Extending the ability for federally qualified health centers (FQHCs) and rural health clinics (RHCs) to furnish telehealth services
  • Delaying the in-person requirement for mental health services furnished through telehealth, including the in-person requirements for FQHCs and RHCs
  • Extending coverage and payment for audio-only telehealth services
  • Extending the Acute Hospital Care at Home (AHCAH) initiative, pioneered by Johns Hopkins two decades ago. It also requires the HHS Secretary to publish a report comparing AHCAH programs with traditional inpatient care delivery. 
  • Extending the ability to use telehealth services to meet the face-to-face recertification requirement for hospice care
  • Extending high deductible health plan (HDHP) safe harbor exceptions for telehealth services in high-deductible health plans.

The final bill did not extend the Ryan Haight in-person waiver for the remote prescription of controlled substances. As mentioned in our earlier article, this is a wise move in this Editor’s view given the abuse of this waiver by certain telehealth organizations. ATA/ATA ACTION release.

The HHS Secretary will be required to submit a report to Congress on the utilization of the above services. The interim report is due in October 2024 and the final report in April 2026, according to the American Hospital Association. Affecting hospitals and practices in the bill:

  • It delayed the statutory Pay-As-You-Go (PAYGO) Medicare 4% sequester for two years, preventing the $38 billion in Medicare cuts that otherwise would have taken effect in January.
  • Partial relief from a 4.5% reduction in physician reimbursement rates starting on 1 January. The legislation reduced the cut to 2% for 2023 and around 3% for 2024.

HealthcareFinance

Other features of this bill having an effect on healthcare and telehealth (from Infrastructure Report Card):

  • $455 million for the expansion of broadband service, including $348 million for the ReConnect program, a series of grants administered by the US Department of Agriculture for the construction, improvement, or acquisition of facilities and equipment needed to provide broadband service in eligible rural areas. This could help rural areas and hospitals in provider-patient and provider-to-provider consults.
  • $1.65 billion for the National Institute of Standards and Technology (NIST), an increase of $424 million, or 34%, above the FY 2022 enacted level. Specific funding is allocated for the measurement labs and research at $953 million, a $103 million or 12% increase above the FY 2022 enacted level. The goal is to spur research advances in cutting-edge fields like carbon dioxide removal, artificial intelligence, quantum information science, and cybersecurity.

The bill was signed into law by the president on vacation in St. Croix, USVI. Given the bumpy start of the 118th Congress today, these are at least not up for grabs.

Funding update, 4 March: big Series Ds for new unicorn Dispatch Health and Tyto Care; USDA’s $42M for rural telehealth; UK’s Perfect Ward hospital inspection app secures £4m

Once upon a time for health tech companies, Series D funding and unicorn status were rare, especially when the tech relates to the under-the-radar, formerly unsexy area of home health. 

  • DispatchHealth, an in-home mobile care provider based in Denver, just closed a $200 million Series D led by Tiger Global with additional participation from Alta Partners, Echo Health Ventures, Humana, Oak HC/FT, and Questa Capital. This comes less than a year after a $135.8 million Series C led by Optum Ventures, The new total of $417 million in funding brings its valuation to a unicorn level of $1.7 bn. DispatchHealth is in the desirable, high potential cost-saving areas of care that replaces ER visits or hospital stays. The platform integrates in-home care services booked through a call, their app, or online by patients, care providers, payers, EMS, senior living, and health systems. The objectives of care are to substitute for ER visits, hospital stays, and to coordinate ancillary services. Currently serving 19 markets across 12 states with care to more than 170,000 patients in 2020, the new funding will be used for expansion to 100 national markets. DispatchHealth recently announced partnering with Humana for advanced hospital-level care for their Medicare Advantage members in several cities. Release, FierceHealthcare
  • More on the health tech side is Tyto Care’s remote diagnostic exam platform. Today they are announcing an additional raise of $50 million, doubling the earlier Series D and now totaling $100 million. Leading the extension is Insight Partners, with participation by Tiger Global (see DispatchHealth), Qumra Capital, Qualcomm Ventures LLC, Olive Tree Ventures, and Shenzhen Capital Group Company. Tyto’s funding is now $155 million and claims a doubling of its valuation. Release.

The US Department of Agriculture (USDA) is surprisingly now an investor in rural telehealth, in part courtesy of the CARES Act from March 2020. (Yes, there were considerable funds left over from that $2.2 trillion pandemic relief bill and now some of them are being used.) USDA is funding projects with a total of $42.3 million, including $24 million from the CARES Act, to improve infrastructure for telemedicine and distance learning infrastructure. Approved to go are 86 projects through the Distance Learning and Telemedicine grant program, to help rural education and healthcare organizations remotely reach students, patients, and outside expertise. USDA’s study found that due to population health, lack of insurance, and lower access to health facilities, there are higher rates of COVID-19 related deaths in rural areas. Healthcare IT News

A UK company that’s in an unusual area of health tech is Perfect Ward, which is designed to put on a laptop and mobile app the complicated process of health inspections of hospitals, care homes, and other health and social care organizations in the UK and internationally. Their £4 million round comes from Octopus Investments (Octopus Group). Current clients include King’s College, Barts Health, The Royal Free and London Ambulance Service. Release (Business Cloud)

University of Mississippi awarded telemedicine Emergency and Specialty Care grant

More details have emerged of one of the projects funded by the $16 million USDA investment announced in February (see TTA 7 February 2014).

The United States Department of Agriculture grant of $378,360 to the University of Mississippi Medical Center will be enhanced by $200,000 from Appalachian Regional Commission [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/03/TESCAN_map.jpg” thumb_width=”150″ /] providing $578,360 for a three-year distance-learning and telemedicine service project  “Telemedicine Emergency and Specialty Care for Appalachia in North Mississippi (TESCAN)”, according to UMMC. UMMC is also the primary site for the Diabetes Telehealth Network we reported in January.

The sites, considered “medically underserved areas” and “health-professional-shortage areas” by the U.S. Department of Health and Human Services, include:

• Calhoun County Medical Clinic, Calhoun City;
• Trace Regional Hospital, Houston;
• Kemper County Medical Center, De Kalb;
• Tishomingo Health Services, Inc., Iuka;
• Webster General Hospital, Eupora;
• Yalobusha General Hospital, Water Valley;
• North Mississippi Medical Center-Pontotoc, Pontotoc;
• Kilmichael Hospital, Kilmichael; and
• Holmes County Hospital, Lexington.

Representatives from the USDA and UMMC announced the grant agreement at a joint press conference at the UBS Building in Jackson.

The grant will expand the number of (more…)

USDA invests $16M in Distance Learning and telemedicine

The US Department of Agriculture is investing nearly $16 million expanding distance learning and [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/02/USDA-Rural-Development.jpg” thumb_width=”150″ /]telemedicine, it was announced on Tuesday, 4th February. The Agriculture Secretary, Tom Vilsack, stated that the Obama Administration is investing in rural telecommunications equipment to help expand access to education, create jobs and improve health care in 25 states. This funding will help to support Obama Administration’s target declared last June to connect 99 percent of students to broadband in the next five years.

The funding is being provided through USDA’s Distance Learning and Telemedicine Loan and Grant program. It provides funding to rural hospitals, clinics, schools and libraries for equipment and technical assistance for telemedicine and distance learning. Grant recipients must demonstrate that they serve rural America, prove there is an economic need and provide at least 15 percent in matching funds.  (more…)