CCHP in the News

CCHP staff frequently contribute to articles on telehealth’s most pressing issues.

  • Policy Report: The Case Against Telemedicine Parity Laws

    John Locke Foundation

    North Carolina is one of 18 states that do not have a telemedicine parity law, which forces insurance companies to pay health care providers for services treated via telemedicine that are otherwise covered during an in-office visit. While most states have such laws, their unintended consequences perpetuate the worst features of our nation’s health care system. Parity laws may impede the creation of a treatment plan that meets the needs of individual patients, raise costs, and conceal the cost of care from the consumer. Telemedicine is thriving in nonparity states like North Carolina, suggesting that the cost and burdens imposed by telemedicine parity laws would likely exceed any benefit.


  • The End of Net Neutrality Could Make Rural Broadband a Heavier Lift

    Politically Georgia

    Within the space of 24 hours last month, two contradictory events reverberated along the Atlanta-Washington D.C. axis.  At the state Capitol, after many months of study, a House Republican task force released its blueprint for saving a rural Georgia bereft of jobs, health care and, increasingly, people.  The foundation for the rescue effort: The extension of broadband internet access that could allow doctors to treat patients remotely, give students in poor school systems access to advanced courses, and provide employers with a firm and speedy connection to the rest of the world.  But one day earlier, the Federal Communications Commission, pushed by its chairman, Ajit Pai, had declared an end to net neutrality – the Obama-era proposition that internet providers should treat all clients and customers equally, as most utilities do.  Instead, the shift will allow providers to give priority – in terms of both capacity and speed – to preferred customers and streaming services.   Those with money will get the cream of internet service. But money is the one thing that rural Georgia hasn’t got.  The full impact of putting an end to net neutrality could take months -- even years – to measure. But it has already sown doubts in the Capitol. Last Thursday, the FCC released a 539-page ruling to back up its decision. That same day, I asked House Speaker David Ralston, R-Blue Ridge, if he and his GOP caucus had been able to digest impact of the FCC’s December ruling. 


  • New Data, Old Glitches Renew Telehealth Debate In Tallahassee

    WUSF Public Media

    Telehealth, telemedicine and distance-medicine are all names for consulting and diagnosing patients from afar with the help of technology like a video conferencing service that Jacksonville OBGYN Daniel Mcdyer uses.  Mcdyer’s software also allows him to take notes, snap pictures and write prescriptions for his mostly pregnant patients, who don’t have to leave home.  He said most doctors aren’t waiting on Tallahassee to implement telehealth technology. But they want to know: Who should be footing the bill? No insurance plans cover visits through his system.  “I give the patients the option of coming to the office to be seen for the problem or being seen virtually, where they’re charged for the visit through their credit card. It’s essentially the cost of a copay,” he said.  As it stands, telehealth costs are mostly passed on to patients. Florida law doesn’t force insurers to cover telemedicine, as 34 states do. Nor does it require them to reimburse doctors the same amount for virtual and in-person visits, something just three states require, according to the national Center for Connected Health Policy.  


  • 9 States with Telehealth Legislation Taking Effect in 2018

    MedCity News

    The Center for Connected Health Policy has unveiled a list of telehealth legislation approved in 2017.  The roundup includes various policies that took effect this past year, as well as one Hawaii policy that’s effective for the plan year beginning on or after January 1, 2019.  But 11 pieces of legislation in nine states will officially take effect in 2018. Here they are:  Arkansas: A policy in the state gives a new definition of telemedicine and includes requirements for establishing a “professional relationship” via telemedicine. Additionally, it contains requirements for when a healthcare worker provides telehealth services to a minor in a school setting and the minor is in the state’s Medicaid program.  California: Two bills (AB 205 and SB 171) let Medi-Cal managed care plans request other access standards if they’ve exhausted all the other options to obtain providers to meet certain standards. They also classify telehealth visits as a means of alternative access standards.


  • 50 states, not quite 50 updated telehealth laws: 5 things to know

    Becker's Hospital Review

    The Center for Connect Health Policy, the federally designated national telehealth policy resource center, published a recap of 2017's state telehealth legislative actions.  Here are five things to know.

    1. All but 16 states updated their telehealth laws in 2017, effective either this year, in 2018 or in 2019.

    2. Among the 34 states that updated their laws, including Washington D.C., 62 legislative bills passed in 2017, up from 48 bills in 2016. 


  • End of Net Neutrality Creates Uncertainty for Rural Telehealth

    Bloomberg BNA

    The repeal of government net neutrality rules could potentially harm rural patients’ ability to speak to a remote physician or electronically send a hospital health information from personal devices.  About 20 percent of Americans live in rural areas “where many do not have easy access to primary care or specialist services,” according to a 2015 American Hospital Association report. With the long-term impact of the Federal Communications Commission’s Dec. 14 decision uncertain, some legal and policy experts told Bloomberg Law that changes to the internet and how access is priced could restrict some rural patients’ access to telehealth services. On Dec. 14, the FCC voted 3-2 to repeal rules barring internet service providers such as Comcast Corp. and AT&T Inc. from slowing or blocking web traffic. The 2015 Obama-era rules reclassified internet access under the Communications Act from an “information service” to a “common carrier service,” moving regulatory jurisdiction of the ISPs solely to the FCC from joint jurisdiction under the FCC and the Federal Trade Commission. Now, the FTC will regain full responsibility.


  • BREAKING: FCC repeals net neutrality rules, potentially affecting telemedicine

    Modern Healthcare

    The FCC voted 3-2 Thursday to repeal net neutrality rules, ending Obama-era regulations that prohibited Internet providers from blocking or slowing web content. Whereas all Internet traffic previously shared same "lane," it can now be split among different lanes with different speeds. Those differing speeds could hurt telemedicine since it requires a "pretty robust connection," said Mei Kwong, interim executive director and policy advisor for the Center for Connected Health Policy. "The last thing you want is for the interaction to suddenly freeze or the audio to go out or for the picture to be pixelated."  Though the FCC could make exceptions for healthcare so it's not subject to the same rules, Kwong and others said, that might still leave patients to fend for themselves.  "What do you do then for the individual who's at home and trying to get services at home?" Kwong asked.  These changes run counter to some recent VA efforts to expand telemedicine, she said. They also run counter to what the majority of Americans want, FCC commissioner Mignon Clyburn said Thursday. "Those very same broadband Internet service providers that the majority says you should trust to do right by you will put profits and shareholders returns above what is best for you," she said.  "When the current protections are abandoned, and the rules that have been officially in place since 2015 are repealed, we will have a Cheshire cat version of net neutrality," Clyburn said. "We will be in a world where regulatory substance fades to black and all that is left is a broadband provider's toothy grin."


  • FCC's Net Neutrality Change May Have Big Implications for Telehealth

    California Health Care Foundation

    At the December 14, 2017, open commission meeting of the Federal Communications Commission (FCC), commissioners will vote on whether to repeal current net neutrality rules. Such action may have wide-reaching impacts on the use of telehealth. Community health clinics, such as federally qualified health centers (FQHCs) and rural health centers (RHCs), could see higher rates for connectivity that may reduce, eliminate, or discourage them from using telehealth to deliver health care services, especially in rural areas. Additionally, telehealth in the home could be severely curtailed as consumers may face higher prices for connectivity that would be sufficient for a telehealth interaction.  Removal of net neutrality rules could negatively impact several other pieces of telehealth policy that have gained traction in recent months at the federal level. The Department of Veterans Affairs has shown increasing interest in using telehealth regardless of where the provider and patient are located. This has been signaled by House passage of HR 2123, recent introduction in the Senate of the Veterans Community Care and Access Act of 2017, and proposed regulatory changes in the program.


  • FCC’s Ajit Pai says net neutrality reform will help telehealth, but experts worry a tiered system complicates connectivity


    With the Federal Communications Commission poised to roll back Obama-era net neutrality regulation, FCC Chairman Ajit Pai has argued that the government’s light touch approach to high-speed internet will be a net benefit for telemedicine.  But industry experts worry that the agency’s reforms will be problematic for healthcare providers, telemedicine vendors, and patients, all of whom require robust connectivity to meet the demands of video consultations that could come at a higher cost.  In a speech last week at a conference about aging and technology, Pai defended the proposed changes, highlighting the potential benefits for telemedicine and remote monitoring, two technologies that are used with growing frequency to care for older Americans.  “One aspect of this proposal I think is worth highlighting here is the flexibility it would give for prioritizing services that could make meaningful differences in the delivery of healthcare,” he said. “By ending the outright ban on paid prioritization, we hope to make it easier for consumers to benefit from services that need prioritization—such as latency-sensitive telemedicine.”  


  • OIG to review Medicaid telehealth payments amid an increase in claims


    The Department of Health and Human Services’ Office of the Inspector General (OIG) plans to audit Medicaid payments for telehealth services to gauge compliance with reimbursement requirements.  The OIG added the review to its work plan this week, noting that Medicaid programs are “seeing a significant increase” in claims for telehealth and telemonitoring services, a trend the watchdog agency expects will continue. The report is scheduled for 2019.  “We will determine whether selected States' Medicaid payments for services delivered using telecommunication systems were allowable in accord with Medicaid requirements,” the OIG update read.  It adds to another audit announced by the agency over the summer, which plans to review Medicare Part B telehealth payments. That review includes a specific focus on telehealth claims provided at distant sites that do not have corresponding claims to originating sites. In an update issued last month, the OIG pushed the date of that report to 2018.  


  • Telehealth Report Offers Glimpse Into Variety and Complexity of State Telehealth Laws and Policies


    In the recently published fall update of the fifth annual edition of its telehealth report, the Center for Connected Health Policy, the federally designated National Telehealth Policy Resource Center, provides a current summary guide to telehealth-related laws, regulations, and policies for all 50 states and the District of Columbia, and tracks a number of telehealth trends. The report offers a revealing glimpse into the scope and complexity of state laws and policies governing telehealth. The authors conclude, however, that despite the fact that state laws and Medicaid policies “differ significantly” certain trends are coming into relief. Here are some highlights of the report: 48 states and the District of Columbia provide reimbursement for live video consults in their Medicaid fee-for service programs.


  • 50 States of Telehealth: 5 Things to Know About State Reimbursement

    Beckers Hospital Review

    The Center for Connected Health Policy released its 50 state scan of telehealth reimbursement laws and Medicaid policies trends report. Here are five report insights:  1. Forty-eight states and Washington D.C. reimburse for some form of live video in Medicaid fee-for-service models. The two states that do not have written definitive reimbursement policies are Massachusetts and Rhode Island.


  • 2 States Expanded Telehealth Reimbursement This Year, but Medicaid Policies are Still Inconsistent


    State Medicaid programs are making incremental progress when it comes to telehealth reimbursement, but there are still broad discrepancies among state policies, according to the Center for Connected Health Policy (CCHP). A biannual update to CCHP’s report on state telehealth laws and reimbursement policies indicates that two states—Maryland and Oklahoma—have implemented new reimbursement policies for store-and-forward telehealth since the organization’s last update in April. Oklahoma also added new payment policies for remote patient monitoring, but CCHP removed Hawaii and Kentucky from that list because there was no indication those states had implemented laws that included reimbursement for remote patient monitoring. As it stands, 48 states and Washington, D.C., provide reimbursement for telehealth that uses live video. Over the last two years, store-and-forward reimbursement has been steadily increasing, but currently just 15 states have enacted some kind of policy. Twenty-one states reimburse for remote patient monitoring, and just nine states pay for all three methods of telehealth.


  • CCHP’s State Telehealth Report Shows Gradual Advances in Coverage

    mHealth Intelligence

    Nearly every state provides Medicaid reimbursement for video-based telehealth, according to the latest report from the Center for Connected Health Policy. In addition, 15 states cover store-and-forward or asynchronous services, and 21 states cover remote patient monitoring – while only nine states reimburse for all three platforms.  But the rules and regulations covering telehealth and telemedicine are as confusing as ever.  “No two states are alike in how telehealth is defined and regulated,” the CCHP points out in its State Telehealth Laws and Reimbursement Policies report, released today. “These differences are to be expected, given that each state defines its Medicaid policy parameters, but it also creates a confusing environment for telehealth participants to navigate, particularly when a health system or practitioner provides healthcare services in multiple states.”  The 262-page report – the group’s fifth annual study - paints an intriguing picture of the breadth and scope of telehealth and telemedicine in the US, and indicates that states are slowly moving to embrace digital health delivery – as evidence by the more than 200 telehealth-related pieces of legislation introduced in 44 states during the 2017 legislative season.  


  • AVMA, AAVMC and AAVSB agree on Telehealth statement


    ​The American Veterinary Medical Association (AVMA), the Association of American Veterinary Medical Colleges (AAVMC) and the American Association of Veterinary State Boards (AAVSB) agree on a statement issued by the AVMA/AAVMC Joint Committee regarding telehealth and veterinary medicine.  “As the veterinary profession’s ‘umbrella’ organization, the AVMA understands that collaboration with veterinary regulatory/licensing boards and veterinary medical colleges is essential to help veterinarians take full advantage of new technologies in ways that best support the health and well-being of their patients,” said Dr. Mike Topper, president of the AVMA.  The statement reads:  Telehealth can provide valuable tools to augment the delivery and availability of high quality veterinary care. According to the Center for Connected Health Policy, “Telehealth encompasses a broad variety of technologies and tactics to deliver virtual medical, health, and education services. Telehealth is not a specific service, but a collection of means to enhance care and education delivery.” Veterinarians need to utilize emerging technologies to enhance accessibility and client communication, while promoting the responsible provision of high quality veterinary medical care. Both AVMA and AAVMC are committed to continue their collaboration with a wide variety of stakeholders to promote access to the convenience and benefits of telehealth, while providing information to the veterinary community about the development of applications and other technologies that help connect veterinarians with clients.