Health Policy Round Up 8.7.19


DHCS releases revised Medi-Cal Telehealth Provider Manual, which includes coverage of e-consults


California bills focused on telehealth coverage face a hearing in Senate Appropriations on August 12th for analysis of their fiscal impact


CMS plans to expand Medicare telehealth benefits and increase health information exchange support

Legislative & Regulatory Developments



DHCS Releases Revised Draft of Telehealth Provider Manual. The new policy delineated in the revised Manual includes e-consult as a covered service and simplifies the billing process for all other synchronous and asynchronous telehealth services. DHCS is still performing system testing and will publish the final web version in mid-August. View the final draft here.

Telehealth bills to meet fate in Senate Appropriations Committee hearing. When the summer recess ends, several telehealth bills will be reviewed by the Senate Appropriations Committee on August 12th, including the following:

View hearing agenda.


S 2084: Telemedicine Across State Lines Act Sen. Marsha Blackburn (R-TN) introduced this bill to create a national telehealth program across state lines. Features include requesting CMS launch CMMI pilots, a five-year rural health grant program, and requiring HHS to create a best practices task force for a national telehealth program. Read more.

CMS publishes proposed Physician Fee Schedule (PFS) for 2020 The proposed PFS for 2020 includes bundled payments for opioids, which can include telehealth encounters for individual and the group psychotherapy element of MAT. It also includes the interprofessional consultation codes for e-consults introduced in the 2019 PFS.  Read more.

Medicare pilot to give providers access to patient claims data using Blue Button..CMS has a pilot program underway to leverage HL7’s Fast Healthcare Interoperability Resources (FHIR) standard to enable clinicians to access claims data directly within their workflow. This new Data at the Point of Care pilot is intended to help better connect clinicians to their patients’ healthcare information via the FHIR API, an improvement in interoperability. Read more.

News Articles, Research & Reports

News: Digital health tool development focus on the ‘worried well’ may be expanding the digital divide In a Tech Crunch article, Sarah Lisker of UCSF discusses the scarcity of digital health tools targeted for the needs of low-income populations. Developers “designing health apps for those who already have access to healthcare, nutritious food, clean air to breathe, and stable housing” are not meeting “the needs of low-income, diverse, and vulnerable patients.” Read more.

Research: Association between broadband expansion and telemedicine use. A Harvard law professor and other health technology experts suggest that, contrary to some expectations, AI might pose a threat to privacy and perpetuate bias in health care, two problems AI is supposed to prevent. And like asbestos “[i]t turns out that it’s all over the place, even though at no point did you explicitly install it, and it has possibly some latent bad effects that you might regret later, after it’s already too hard to get it all out.” Read more.

News: J.D. Power to Publish First-Ever Telehealth Satisfaction Study in November 2019. In its study, J.D. Power plans to track awareness and selection, enrollment, consultation, billing and payment, and customer service for direct-to-consumer, payer-owned and health system-owned telehealth provider types. “We know from our insurance market research this year that half of healthcare insurance consumers are considering telehealth as an alternative to traditional primary care, so we are interested in developing telehealth research in order to understand how consumers experience new technology in healthcare and how it affects their overall satisfaction with different providers,” said James Beem, J.D. Power’s managing director of Healthcare Intelligence. Read more.

Research: Payer telehealth program estimates $15M in savings Based on 2017-2018 data, Health Care Services Corp. participating group employers saved more than $15 million— which translates to savings of 39 cents per employee per month. 85% of HCSC’s members who used Virtual Visits avoided a more expensive care setting, such as urgent care and emergency department visits, with overall medical costs 17 percent lower for Virtual Visit users than for non-Virtual Visits users. Read more.