Health Policy Round Up 10.16.19

On October 13th, Governor Newsom signed six telehealth-related bills that will impact telehealth expansion throughout California. Among the signed bills is A.B. 744, which requires telehealth payment parity for commercial payers by January 1, 2021. Newsom also signed A.B. 1264, which allows providers to use telehealth to conduct examinations prior to prescribing, dispensing or furnishing drugs so long as the examination meets the standard of care. This strengthens the legal foundation needed to ensure the growth of telehealth to provide t right care at the right time in the right place.

Other developments across the country underscore the continual growth of telehealth for care delivery. Large employers, such as Amazon, are expanding telehealth benefits and in addition government-funded health services are making efforts to provide telehealth services in non-traditional settings, such as schools and prisons.

Legislative & Regulatory Developments

California Legislature — Bills Signed by Governor Newsom

AB 744: Telehealth payment parity for commercial payers

Requires commercial payers to reimburse network providers for any covered service provided through telehealth at the same rate as comparable services provided in person. Medi-Cal managed care plans are exempted from this requirement
Affects contracts issued, amended or renewed on or after January 1, 2021.

A.B. 1264: Prescribing via telehealth

Specifies that synchronous interactions through telehealth can be used to conduct appropriate examinations prior to prescribing, dispensing or furnishing drugs, so long as the provider complies with the standard of care

A.B. 1494: Medi-Cal telehealth reimbursement in emergencies

Removes any face-to-face or patient physical presence requirements in order for a community health center to receive reimbursement for telehealth or telephonic services provided during a state of emergency.
Required DHCS to obtain any federal approvals (i.e., State Plan Amendment) to implement this law

AB 1519: Teledentistry professional responsibilities, conduct and standards of practice

Specifies that all dentistry laws related to standard of care apply to care provided through telehealth
Dentists providing services through telehealth must provide their name, telephone number, practice address and state license number to patients

AB 1642: HCS approval, EQRO review of alternative access plans including telehealth; enforcement and contract recission for noncompliance with network adequacy standards.

SB 24: College health center access to medical abortion, including via telehealth, and telehealth startup funding

Allots each UC and CSU campus $200,000 to pay for the startup costs related to the mandate to provide medication abortion at student health centers
Startup funds can be allocated to enable telehealth services

California Legislature — Bills Vetoed by Governor Newsom

AB 848: Medi-Cal coverage of continuous glucose monitors

Would have required DHCS to add continuous blood glucose monitors as a benefit in the Medi-Cal program

Other States

Pennsylvania legislators introduce new telehealth legislation The Telemedicine Act (SB 857) aims to establish definitions for telemedicine and telehealth, provide temporary evaluation and treatment guidelines and ground rules for reimbursement, and give state departments up to two years to draft permanent rules and regulations. Read the text of the bill here.

News Articles, Research & Reports

Behavioral Health

How Millennials and Gen Z address health issues with digital tools On October 17th, the president and CEO of HopeLab Margaret Laws will deliver a keynote address at the HIMSS Connected Health Conference entitled “How Digital Natives are Changing Digital Health.”. During her talk, she will explore how the “lifestyles, expectations and perspectives” of Millennials and Gen Z, which make up more than 50% of the U.S. population, are changing the landscape of digital health. Read more here.

Employers

Amazon Care App to feature telehealth Amazon Care is a mobile app that currently provides Seattle-based Amazon employees with access to virtual healthcare services from Oasis Medical Group, including video visits and text chats with providers. Read more in The Verge’s coverage here.

Health Systems

Henry Ford Health’s remote patient monitoring program saw 45% drop in ED readmission rate Henry Ford’s remote patient monitoring program, called e-Home Care, provides enrolled patients with a tablet loaded with mHealth applications and Bluetooth-enabled wireless devices. For patients with chronic health issues or those recovering from cardiothoracic or transplant surgery, the wireless devices gather biometric data and send it to care teams. Read more in the press release.

Payers

Humana and Seniorlink launch telehealth for seniors The program, which provides telehealth access to 250 MA members, is designed for seniors with chronic health concerns and other functional challenges and is focused on keeping them out of assisted living facilities and in their own homes. Read the press release here.

CVS to turn stores into HealthHUBs CVS is renovating 1,500 of its stores into HealthHUBs to focus more on health services, including a tech-enabled healthcare within brick-and-mortar clinics. Read the press release here.

Policy

American Academy of Family Physicians (AAFP) endorses interstate medical licensing compact At its recent National Congress, AAFP voted to lobby states to join the Interstate Medical Licensure Compact and encourage their legislatures to adopt interstate licensure. Read the press release here.

Providers and life sciences companies do not believe that health tech developers understand the complexities of the digital health market In a recent survey, three in five respondents highlighted longstanding business and reimbursement practices as a clear roadblock for digital health products going to market. In addition, a lack of demonstrated value by health tech developers has created a long “pause” in the establishment of healthcare partnerships between developers and providers. Read the report here.

State Innovations

Incarcerated women in Kentucky access opioid treatment via telehealth The University of Kentucky will receive an $8.8 million grant from NIDA to create the Kentucky Women’s Justice Community Opioid Innovation Network. The connected health program is designed to give these women access to treatment as they transition out of prison and back into their communities. Read the press release here.

Nevada health centers to bring telehealth to schools Nevada Health Centers (FQHC) will provide telemedicine carts to almost 40 schools in three Nevada counties using $1 million in state funds. Read more here.

Mike Buhl graduated from the University of Virginia with a double major in Systems Engineering and Economics in May of 2016. Mike is currently in his second year with Ernst & Young, where he serves as a technology consultant within the financial services sector. He has consulted for multiple financialinstitutions, including a leading US broker-dealer, a government-sponsored mortgage enterprise, and a banking institution. Mike currently lives in Arlington, Virginia.

During the summer of 2014, Mike was an intern at BluePath Health, which he says was an incredible and valuable experience. He had first-hand experience of the consulting lifestyle, and felt like part of the team. During the summer, he interacted with clients, participated in meetings, took ownership of work products, and learned all about the healthcare industry, telehealth initiatives, and consulting. For one project, he create heat maps and the visualizations of OSHPD specialist data for California counties to highlight specialist needs and pinpoint telehealth opportunities. The skills he gained from his internship still help his career today.

Callie Monroe Watts is currently sophomore at the University of California, Santa Barbara where she majors in economics. She has just been accepted to a study abroad program in London for fall 2018.

Her summer working at BluePath Health was an amazing experience. First of all, she worked under people passionate and knowledgeable about their field, which she found very inspiring. She also increased her understanding of the current health care ecosystem, including its structure, its flaws, and its future. Last but not least, she improved her research and synthesizing skills while collecting data and information about different health care companies.

Jacqueline (Jackie) Wilson is a graduate student at the University of California, Berkeley, where she is obtaining a Master of Public Health degree in Health Policy and Management. During her summer internship with BluePath Health (BPH), she served as a policy analyst for client engagements across both private and public sectors. For a healthcare software startup, she conducted a funding research and strategy analysis that identified key federal and state grant opportunities in response to the COVID-19 public health emergency. In addition, for Marin County’s “Marin 9 to 25” youth equity project, she developed a landscape analysis that has informed the project committee’s next steps and recommendations. Lastly, Jackie gained new experience in coalition building through the California Telehealth Policy Coalition, for which she monitored ongoing policy proposals and developed materials for committee meetings and webinars. For these projects, her creative problem-solving, communication, and analytical skills were significant additions to the BPH team.

Prior to starting graduate school, Jackie was a senior consultant at Booz Allen Hamilton where she worked on a variety of compliance, technology, and policy projects for the Center for Medicare and Medicaid Services (CMS). She also had internships with UnitedHealth Group’s Office of Government Affairs and the Office of the National Coordinator for Health IT in Washington D.C. Her bachelor’s degree in Business Administration is from the University of Notre Dame, where she double-majored in Information Technology Management and Political Science.

Lauren Jacobson joined BluePath Health as a Manager in 2021 with experience in program management, resource development, and communications. Her work focuses on implementing projects for youth health and wellness in Marin County, partnering with community-based organizations, schools, government agencies, health care providers, and funders.

Prior to joining the BluePath Health team, she was a Program Manager for a California safety-net organization, where she oversaw projects for foster care, behavioral health, First 5 centers, and transitional-aged youth (TAY) programs. Her past experience includes developing communications and access strategies at the Foundation for Innovative and New Diagnostics, as well as consulting for CellScope Technologies and Gilead Sciences. She also gained experience in research and data analysis for HIV prevention as a USAID Global Development Fellow for the MatCH Research Institute. Lauren holds a BA in Sociology from Vassar College and a MDP from University of California, Berkeley.

Erika Cerutti has over 20 years of experience in bookkeeping and executive administration for a variety of industries. She brings her combined expertise in technical bookkeeping and professional soft skills to help BluePath Health achieve their objectives.

Managing accounting functions, project schedule coordination, and client service with aplomb, Ms. Cerutti is well-established as an office manager and bookkeeper extraordinaire in Marin County. Skilled at project coordination and developing administrative systems, she also possesses professional empathy and discretion with her background in nursing. Ms. Cerutti began her career as a registered nurse at Berkeley-Orinda Women’s Health and with Marta Spain, M.D., in Greenbrae.

Ms. Cerutti holds a Bachelor of Science in Nursing from the Samuel Merritt School of Nursing at Saint Mary’s College. She earned a registered nurse license and public health nurse license, then later obtained a national bookkeeper certification and a certificate of applied accounting.

Ciara Keegan is researcher and grant writer who joined BluePath Health in 2020. During the summer of 2018 as a BPH intern, she worked with the Public Health Department of Marin County’s RxSafe program and also provided research and writing for presentations and reports focused on telehealth and healthcare policies. Now, as a full time BPH team member, she provides high-quality research for projects regarding Medicaid telehealth reimbursement and barriers to telephone and broadband access that low-income Americans face. She is also working on a Marin-based youth wellness project called “Marin 9 to 25”.

She holds a BA in Science, Technology and Society from Brown University, where she studied Science and Society with a focus on Health and Medicine

Adina Safer is a healthcare consultant with more than 20 years of deep industry experience focused on new product development, technology adoption and complex program management. With this experience, she provides clients with a broad understanding of stakeholder positioning among industry leaders, physicians, key academic medical centers and clinics. Her expertise includes addressing market access challenges as well as developing reimbursement and commercialization models for biotech, medical device and digital health companies. Her clients span payers, pharmacy benefit managers and Medicare for whom she drives commercialization. Past experience includes 12 years with CVS as well as work with start-ups, venture capital firms and Fortune 500. She holds a BA from Columbia University and a MBA/MPH from University of California, Berkeley.

Emily Brower Auchard has 20 years of experience providing communications, content strategy and editing services for technology, biotech and health care companies of all sizes. Her work at BluePath Health has included white papers on health IT topics, such as telehealth and health information exchange, and isssue briefs on California health IT policy. She also provides content strategy and development for BluePath Health clients for blogs and social media.

Her previous work in health care includes developing user interface copy for consumer-facing health care technology and producing case studies on health care application design and architecture for companies such as Practice Fusion and MedicaLogic.

While working in the the high-tech industry, she provided communications services for a wide range of technology companies including industry leaders, including Apple, NeXT Computer and Sun Microsystems, as well as many start-ups.

Ms. Auchard holds a B.A. with Honors from Wesleyan University in Middletown, CT.

John Weir has over 18 years of senior management experience in healthcare technology, spanning an array of national and regional initiatives. With a rich history in vendor client services leadership, he has paved the way in EHR and population health management software rollout and integrations, building methodologies and teams focused on client satisfaction and product utilization. He has a keen ability to effectively align technology use with strategies to improve outcomes and quality across the care continuum.

Mr. Weir’s skills include developing large-scale programs and new service lines for both private and government clients and completing many large-scale clinical data integration projects for hospitals and physician organizations. He has provided project management of an Office of the National Coordinator (ONC) CMMI grant with 15 healthcare organizations to leverage healthcare data analytics to improve care coordination and population health management. He also led a pioneering EHR adoption program for primary care physicians, funded by the Centers for Medicare and Medicaid Services (CMS), called DOQ-IT. This program offered insight into technical assistance, financial incentives and EHR systems requirements that could aid CMS in achieving higher EHR adoption rates.

As a client services executive, he has led implementation and account management teams for organizations including Phytel Inc., Allscripts and Lumetra Healthcare Solutions, driving new business and excellent client satisfaction results. As a business leader, he provides strategy development, business planning, and project execution for organizations and is adept at influencing multi-stakeholder groups to ensure team harmonization and delivery of commitments within tight budgets and aggressive deadlines.

John holds a bachelor’s degree with honors in history and political science from the University of Ulster in Northern Ireland. Additionally, he completed graduate-level courses in computing and information systems at University of Ulster in Northern Ireland before starting his career in healthcare technology.

As BluePath Health’s (BPH) Director of Policy, Robby Franceschini supports clients’ strategic needs for health policy, government relations and business development. His expertise encompasses Medi-Cal, telehealth and health information exchange (HIE) and his client experience includes work with foundations, government agencies, health care start-ups and payers. Prior to joining the BPH team, Robby worked with Cleveland Clinic’s legal department and also supported Medi-Cal policy development at the National Health Law Program’s Los Angeles office. He also gained experience in science and technology policy and ethics as an AAAS Emerging Leaders in Science and Society Fellow and research assistant for NIH- and Wellcome Trust-funded projects. He holds a BA, JD and MPH from the University of Washington.