Health Policy Round Up 5.6.19


This week we review state legislation and proposed regulations that acknowledge telehealth as a network adequacy standard for
health plans. Several states, including California, are determining how plans will account for telehealth provider networks as they try to meet access standards with telehealth access. In the coming weeks, several California bills affecting telehealth are slated to be heard by the Appropriations Committees.


Legislative/Regulatory Developments


Research & Reports

Funding Opportunities

Recent Policy Hearings and Meetings

Forthcoming Policy Hearings and Meetings

Legislative/Regulatory Developments



AB 1264 (bill): Reinforces that in-person exams are not required to virtually prescribe birth control

  • passed Assembly Appropriations
  • amended as an urgency statute
  • will take effect when signed by Governor

AB 1689 (bill): Creates a grant program for UC, CSU and community college campuses to establish or expand access to mental health services

  • re-referred to Assembly Appropriations
  • set for hearing on May 8

Other States

Washington, D.C. 26 A DCMR (proposed regulation): Requires that insurers’ access plan submissions describe how telemedicine is used to meet standards

  • passed Assembly Business and Professions, referred to Appropriations

Florida SB 1526 (bill): Prevents health plans from using providers who provide services exclusively via telehealth to meet network adequacy standards

  • passed Senate Health, referred to Appropriations

Minnesota HF 551 (bill): Waives certain network adequacy standards for plans using telehealth

  • referred to Health and Human Services Division of state House

West Virginia HB 3019 (bill): Requires that insurers’ access plan submissions describe how telemedicine is used to meet standards

  • referred to Committee on Health and Human Services




STAT News: FBI Hears Allegations About Improper Billing by UBiome, a Microbiome Test Startup Which Supports Orders with Telehealth

  • The FBI is investigating allegations concerning the billing practices of UBiome, a microbiome start up that uses telehealth to enable its network of physicians to order tests for patients. The allegations claim that UBiome has changed the billing codes it uses for reimbursement claims in a way that may be illegal.

Health Affairs: Healthcare’s Hidden Opportunity Costs Could Be Solved by Leveraging Telehealth

  • An analysis of 100,000 interviews on time use reveals physician visits require an average of two hours of patients’ time, including travel, clinic waits and only 20 minutes spent with a physician. In addition, the average amount of “lost wages associated with a visit was $43—more than the out-of-pocket payment for the visit itself.” Leveraging connected care tools, such remote patient monitoring, video visits, and mobile health applications to bring care to patient homes, offers one solution to unburden this time cost for patients.

CHCF: Catalyzing Coordination: Technology’s Role in California’s Whole Person Care (WPC) Pilots 


  • This report describes how California counties are using technology, including EHRs and other care management platforms, to coordinate care in Medi-Cal’s WPC pilots.

Funding Opportunities


NIH & AHRQ: Planning Grants for Pragmatic Research in Healthcare Settings to Improve Diabetes and Obesity Prevention and Care (R34 Clinical Trial Required) Seeking proposals for pilots addressing diabetes and obesity prevention focused 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) Seeking 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 seeks proposals on the use of technologies, including remote healthcare, that improve patient outcomes. Ongoing standard NIH application dates.

USDA: Distance Leaning & Telemedicine Grants USDA seeking proposals to support SUD morbidity and mortality reduction 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 Meetings


April 29th: California Health Care Foundation Briefing: Improving Quality in Medi-Cal Managed Care

  • Overview of the state of Med-Cal managed care quality measurements and proposals to reform quality reporting and incentives.

Upcoming Policy Hearings and Meetings


May 6th: California Health Care Foundation Briefing 

  • Expanding the Scope of Practice for Nurse Practitioners

May 8th: Assembly Appropriations

  • bills include AB 385 (EPSDT performance), AB 744 (telehealth parity), AB 1676 (maternal and child telemental health), AB 1689 (college mental health)

May 13th: Senate Appropriations

  • bills include SB 24 (college abortion access)