Health IT organizations and telehealth advocates are lauding the inclusion of telehealth provisions in a new spending bill signed by President Donald Trump on Friday morning, along with some regulatory relief tied to EHR requirements and several new opportunities for additional health IT funding.
After a five-hour government shutdown that kicked in at midnight on Thursday, the House voted to approve a $400 billion bipartisan budget deal Friday morning, hours after it passed through the Senate The massive spending package features funding for several health programs, including a four-year extension for the Children’s Health Insurance Plan (CHIP). The bill also raises the federal deficit by an estimated $320 billion and keeps the government open until March 23 while lawmakers decide how to distribute funding to federal agencies.
Throughout the week, health IT advocates applauded several provisions included in the bill, including portions of the CHRONIC Care Act which allows Medicare Advantage plans to include telehealth coverage beginning in 2020. The budget agreement also expands reimbursement for dialysis patients and telestroke services, a provision the College of Health Information Management Executives (CHIME) highlighted as a key opportunity for providers.
“This sends a strong message that in a package this large that addressed so many critical programs and policies, health IT is in there and being put forward as a tool alongside some of the other bigger policies,” Samantha Burch, the senior director of congressional affairs at HIMSS told FierceHealthcare.
WARNING THIS IS A WONKY THREAD: Tucked into the bill signed are the most significant changes ever made to Medicare law to use Telehealth. It will increase access and quality of care, and reduce costs using tech that’s already available. A few very cool examples here:— Brian Schatz (@brianschatz) February 9, 2018
SCAN Health Plan, which offers Medicare Advantage coverage in California, was a proponent of the CHRONIC Care Act. The group’s CEO Chris Wing said he was “heartened by the expansion of telehealth services” included in the spending package, adding that virtual care will be critical to caring for populations with special needs or chronic conditions.
“It’s not just needed in rural areas, but in urban areas, where barriers to care still exist,” Wing said in an email. “Giving Medicare Advantage the ability to offer telehealth services as part of the basic benefit package will help improve access to care and, by extension, improve the care itself.”
Although the bill expands telemedicine for a subset of individuals, proponents say it could build momentum for future legislation. New data that will come out of expanded coverage in the Medicare Advantage program could be an important driver in furthering telehealth coverage across Medicare, although standalone legislation will face significant barriers during an election year.
“I think what will be telling is the list of eligible services that they’ll allow the managed care plans to reimburse for,” Mei Wa Kwong, executive director for the Center for Connected Health Policy said in an email. “If it’s a limited, small list, there may not be much interest by the plans to offer it. But if hits upon services that have a lot of appeal, we can definitely see some good uptick in the number of services being delivered and with that, after a period of time, some good data.”
Meaningful Use relief
The legislation also includes a measure that would amend language in the HITECH Act to prevent Meaningful Use requirements from becoming more stringent over time. CHIME Board of Trustees Chair Cletis Earle said building Meaningful Use flexibility into the bill was a “positive step.” Earle testified last year in support of the bill, originally introduced by Rep. Michael Burgess, R-Texas, where he acknowledged the “ongoing challenges our members continue to encounter in the Meaningful Use program.”
But it’s still unclear exactly how that will impact providers moving forward since it gives broad authority to the Secretary of the Department of Health and Human Services to shape the future of the program. For the Centers for Medicare & Medicaid Services, which is acutely focused on reducing provider burden, it provides an opportunity to reshape EHR requirements and focus on interoperability.
“It could be applied a number of ways,” Burch says. “My assumption would be it was written broadly on purpose to really allow some thought around what’s best for the overall picture when it comes to what role the Meaningful Use program should play.”
Higher spending caps
Another indirect but equally important benefit of the spending package is an increase in nondefense discretionary spending caps, an issue that HIMSS has backed for some time.
While Congress has yet to hash out exactly where that money will end up, the importance of technology and data across a range of healthcare agencies opens up more opportunities for the industry.
“Health IT now touches every single part of health and healthcare,” Burch says. “Every single agency has some intersection with health IT. It can’t just be in a space where we’re looking at ONC. We need to be looking more broadly.”