Health Policy Round Up 4.12.19

 

In California, this week’s legislative developments underscore Senate and Assembly support for telehealth as a care delivery mode. Similar legislation is trending on the federal level as evidenced by the CMS’s new rule that allows Medicare Advantage plans to include telehealth as part of their basic benefit packages.

 

Legislative/Regulatory Developments

Litigation

News Articles

Research & Reports

Funding Opportunities

Recent Policy Hearings and Meetings

Forthcoming Policy Hearings and Meetings

Legislative/Regulatory Developments

 

California

SB 612 (Pan): Health Plan Reporting

  • Requires health plans, insurers and medical groups to report additional enrollee and condition-specific metrics, such as CAHPS and HEDIS measures
  • Passed Senate Health and referred to Appropriations Committee

AB 1689 (McCarty): College Mental Health Services Program

  • Creates state fund for CSU and UC mental health services
  • Passed Assembly Health and referred to Education Committee

AB 1642 (Wood): Medi-Cal: managed care plans

  • Requires plans with alternative access standards to arrange for non-emergency medical transportation for members
  • Passed Assembly Health and referred to Appropriations Committee

AB 1529 (Low): Telephone medical services

  • Specifies that out-of-state providers providing telephone services must supply information to California licensing boards
  • Passed Assembly Health

AB 1494 (Aguiar-Curry): Medi-Cal: telehealth: state of emergency

  • Requires Medi-Cal to reimburse FQHCs and RHCs for services provided through telehealth during or within 90 days of a declared state of emergency
  • Passed Assembly Health and referred toAppropriations Committee

Federal

CMS Final Rule for Medicare Advantage (MA) Telehealth: Authorizes MA plans to include additional telehealth benefits in their bids. Plan Reporting

CMS Proposed Medicare Coverage of RPM for Hypertension: Would allow for annual coverage of remote blood pressure monitoring for beneficiaries with hypertension

Litigation

 

DOJ Telehealth Fraud Indictment: Four Men and Seven Companies Indicted for Billion-Dollar Telemedicine Fraud Conspiracy)– Federal prosecutors in Tennessee have accused several providers of $1 billion in telehealth fraud, alleging they fraudulently marketed and sold dietary supplements, skin creams, and testosterone via telemedicine 

News Articles

 

WSJ: Amazon Wants You to Use Alexa to Track Health Care Now that Amazon’s Alex is HIPAA-compliant several health IT providers, payers and health systems, including Livongo, Cigna , Providence St. Joseph Health and Boston Children’s Hospital, are using Alexa for remote patient monitoring and other applications.

Washington Post: Is your pregnancy app sharing your intimate data with your boss? Digitally tracking pregnancies on apps may be more public than users are aware. New “femtech” ovulation apps, such as Ovia, which help woman track menstrual cycles, ovulation and pregnancy are also sending aggregated, sensitive data to insurers and employers.

Financial Times: Alphabet and Apple take divergent paths in health Alphabet, Apple and drug companies are bullish on the potential of wearable devices to diagnose health problems and test treatments, leading to more robust clinical trials.

Research & Reports

 

Pediatrics: Antibiotic Prescribing During Pediatric Direct-To-Consumer Telemedicine Visits Use of commercial direct-to-consumer (DTC) telemedicine is increasing among children and acute respiratory infections (ARIs) are the most commonly diagnosed condition during DTC telemedicine visits. Findings of this retrospective study of claims data reports that children may be over-prescribed antibiotics via live video visits, sometimes out of line with the standard of care.

Funding Opportunities

 

HRSA: Innovations in Access to Care for Children and Youth with Epilepsy This program supports the use of telehealth to improve youth health care transition processes and communication and collaboration between primary and specialty care for children and youth with epilepsy (CYE) in medically underserved and/or rural areas. Proposals due 4/22/19.

NIH & AHRQ: Planning Grants for Pragmatic Research in Healthcare Settings to Improve Diabetes and Obesity Prevention and Care (R34 Clinical Trial Required) This funding opportunity seeks proposals for pilots addressing diabetes and obesity prevention with a “focus on approaches with the potential to be broadly disseminated outside the specific setting where it is being tested”. Proposals due 5/14/19.

NIH & AHRQ: Pragmatic Research in Healthcare Settings to Improve Diabetes and Obesity Prevention and Care (R18 Clinical Trial Required) This funding seeks proposals to test innovative strategies for diabetes and obesity prevention in “healthcare settings where individuals receive their medical care”. Proposals due 5/14/19

NIH: Use of Technology to Enhance Patient Outcomes and Prevent Illness (R01 Clinical Trial Optional) NIH is seeking proposals on the use of technologies, including remote healthcare, that improve patient outcomes. Ongoing standard NIH application dates.

USDA: Distance Leaning & Telemedicine Grants USDA’s telemedicine grants seek proposals to support the reduction of SUD morbidity and mortality in high-risk rural communities by expanding prevention, treatment and/or recovery capacities at community, county, state, and/or regional levels. Proposals due 5/15/19.

Recent Policy Hearings and Meetings

 

April 10th: ONC HITAC: Information Blocking Task Force HITAC is working with ONC to provide guidance for a final rule on information blocking and interoperability.

April 10th: ONC HITAC: Health IT for the Care Continuum Task Force The Task Force met with ONC to discuss draft recommendations on EHR certification for pediatric settings.

Forthcoming Policy Hearings and Meetings

 

April 22nd: Assembly Budget Subcommittee on HHS, Informational Hearing

April 23rd: Assembly Health Committee, Bill Hearing

April 24th: Senate Health Committee, Bill Hearing

April 25th: Senate Budget and Fiscal Review Subcommittee on Health, Informational Hearing