The Federal Communications Commission voted 3-2 in favor of repealing net neutrality regulations, an expected outcome that prompted renewed concern from some about the impact on telehealth and remote monitoring.
In a release (PDF) following Thursday’s vote, the FCC lauded the reversal of “heavy-handed utility-style regulations” that would promote network investment that is “key to closing the digital divide, spurring competition and innovation that benefits consumers.”
But the hotly debated change was met with an immediate legal challenge from more than a dozen states, led by New York Attorney General Eric Schneiderman, who released a video shortly after the vote vowing to “stop the FCC’s illegal rollback of net neutrality.” Schneiderman said his office is investigating a flood of fake comments submitted to the FCC’s site.
Exactly what impact the repeal will have on healthcare remains to be seen, but telehealth advocates have raised concerns that the new regulatory environment could erode telehealth and remote monitoring functionality for providers, patients and vendors, particularly those in rural parts of the country.
“Telehealth doesn’t work if you don’t have that connectivity,” Mei Wa Kwong, J.D., interim executive director and policy adviser at the Center for Connected Health Policy, told FierceHealthcare last week. “It's an essential element of telehealth. If you price people out, they aren’t going to be able to use it.”
Following Thursday’s vote, Kwong cautioned that “there’s still a ways to go,” citing the legal challenges and the potential for congressional action.
In an email to FierceHealthcare, health law attorney Lisa Schmitz Mazur, a partner at McDermott Will & Emery, worried that the repeal “could further widen the gap between the ‘haves’ and the ‘have nots’ when it comes to access to high quality and timely healthcare services.”
She also highlighted the possibility that small and rural providers might cut or abandon telehealth programs that require a higher price tag for connectivity. Those same rural communities often rely on telestroke and telepsychiatry services to support patient care.
AMIA, which has previously categorized broadband access as a social determinant of health, said in a statement that it “continues to advocate for principles of a free and open internet,” reiterating the importance of high-speed internet access that will take on a bigger role in the future of medical care.
“It is critical that the digital divide and health disparities are not exacerbated by policy—or the lack thereof,” the statement read. “We will continue to monitor this issue closely, as there will be various legal challenges, and likely interest from both Democrats and Republicans on the Hill.”
One group that has remained steadfastly silent on the issue is the American Telemedicine Association. When asked for comment, a spokesperson said the organization is “remaining neutral on the issue of net neutrality.”
Buried in the news of the net neutrality repeal was a separate move by the FCC to expand funding for the Rural Health Care Program, which assists providers in getting broadband access to support telehealth and remote monitoring programs. The agency voted (PDF) to waive the $400 million funding cap for fiscal year 2017—which runs from July 1, 2017, to June 30, 2018—and carry forward any unused funds from prior years.
Moving forward, the agency plans to issue proposed rulemaking that considers increasing the annual limit and creating a prioritization mechanism for funding.