Dear Colleagues,
We hope you're doing well and have enjoyed a wonderful start to 2023! We're here with another edition of Northeast Connections to help you prepare for another year filled with telehealth opportunities and events!
The end of 2022 was filled with exciting telehealth updates and opportunities and December continued the theme; Between Federal Policy Movement, Request for Comments on upcoming Federal efforts, and State level programmatic opportunities, there was lots of important considerations for telehealth afoot for all avenues of care. As you've come to expect, the NETRC team has what you need to catch up, and lots of telehealth updates to share with you this month! T his edition aims to help you digest the multitudes of things happening across the telehealth landscape; including: NETRC23 Conference Updates (save the date!), NCTRC member Resources, Upcoming Webinars & Events for 2022, & so much more!
As always, please don't hesitate to reach out with your telehealth questions, success stories, or just to say hello; we hope to hear from you!
On behalf of the entire NETRC Team – Be Well,
Reid Plimpton, MPH - Project Manager
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Upcoming Webinars & Events |
Open Funding Opportunities |
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SAVE THE DATE! NETRC's 9th Annual Conference: 9/18-9/19/2023 |
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We're thrilled to announce the dates of our 9th annual conference, which will be held in on September 18th-19th, 2023.
- Location
- Registration and Hotel Booking information
- Call for Abstracts
- Speaker Updates
- Sponsor and Industry Partner Opportunities
- and so much more!
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Resources from around the NCTRC |
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The National Association of Community Health Centers (NACHC) Presents:
New Telehealth Resources for Health Centers
NACHC is excited to collaborate with National Health Center Telehealth Resource Center (TRC) to pilot a project intended to provide technical assistance (TA) to health centers who are determining how and if they will sustain telehealth operations and virtual modalities coming out of the COVID-19 pandemic and Public Health Emergency designation (PHE). Find out more about this joint project below.
TA products available:
3. Direct Telehealth Billing Technical Assistance/Triage –Targeted TA for FQHC telehealth billing questions now has a dedicated consultative service available triaged by the Center for Connected Health Policy, email: FQHCquestions@cchpca.org
National Health Center Telehealth Resource Center (TRC):
A NACHC-TRC Joint Project for FQHCs Telehealth Operations
•FQHCs are encouraged to reach out to their TRC for their telehealth questions. Check NCTRC website to find your TRC.
This project supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $1,656,250 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.
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CCHP is now making a factsheet available summarizing the findings from our new FQHC section. CCHP searched statute, state Medicaid manuals, administrative code and fee for service polices between July and early September 2022, for relevant policies. In some categories, the factsheet reports a certain number of states that are reimbursing for a specific modality or the prospective payment system (PPS) rate. Note that CCHP only counts states as providing reimbursement if official and explicit Medicaid documentation was found confirming they are reimbursing FQHCs specifically for a certain modality. A broad statement that all providers are reimbursed or any originating site is eligible without an explicit reference to FQHCs was insufficient. Additionally, a state Medicaid program was counted as reimbursing FQHCs even if they do so in a very limited way, such as only for mental health.
KEY FINDINGS INCLUDE:
- Definition of Encounter/Visit: The majority of Medicaid programs do provide a definition for a FQHC ‘encounter’ or ‘visit’ that stipulates that it is a face-to-face interaction. This does not necessarily preclude use of telehealth as live video can also be considered ‘face-to-face’.
- Same-Day Visits: CCHP examined each state Medicaid program’s policy on ‘same day encounters/visits’. Many states have limitations around FQHCs claiming more than one encounter in a single day for a single patient. This is thought to be a limitation applicable to telehealth because it is common for a patient to visit a FQHC for a primary care visit, and upon examination require a specialty service (such as mental health). CCHP observed that most state Medicaid programs do indeed have limitations around same day encounters, particularly if the services occur at the same location and are both considered the same type of encounter (for example, a medical encounter). However, there are often allowances for multiple encounters if the service is considered a different type of encounter, for example a mental health encounter.
- FQHCs as Originating Sites: 36 states and DC explicitly allow FQHCs to serve as originating sites for telehealth-delivered services. If a state does reimburse a facility fee, it is common for FQHCs to be eligible to collect the fee, however not every state Medicaid program reimburses the facility fee
- FQHCs as Distant Site: 34 states and DC explicitly allow FQHCs to be distant site providers. This was often stated in Medicaid manuals or regulations as a clarification so that there could be no confusion about their eligibility for reimbursement.
- FQHCs Collecting the Prospective Payment System (PPS) Rate: In some cases, policy addressed whether or not FQHCs would be eligible for the prospective payment system (PPS) rate. Twenty state Medicaid programs and DC explicitly clarify that FQHCs are eligible for the PPS rate when serving as distant site providers.
- Store and Forward Reimbursement: The vast majority of states did not specify or excluded store-and-forward from an eligible service FQHCs could be reimbursed for. Only 4 state Medicaid programs explicitly reimburse FQHCs for store-and-forward.
For more detailed explanations, examples of each topic area above, and a chart reporting whether each state reimburses FQHCs for the specific modalities or PPS rate, see the Telehealth Policies and FQHCs Factsheet.
For each state’s specific FQHC policies,
along with links to source materials,
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ICYMI: CCHP's UPDATED 50 STATE TELEHEALTH POLICY REPORT |
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In early 2023, the Center for Connected Health Policy (CCHP) released its bi-annual summary of state telehealth policy changes for Fall 2022. Additionally, we are also making available a summary chart showing where states stand on many key telehealth policies, as well as an infographic highlighting our key findings. The most current information in CCHP’s online policy finder tool may be exported for each state into a PDF document. The Fall 2022 summary report adds in two new jurisdictions, Puerto Rico and Virgin Islands, and covers updates in state telehealth policy made between July and early September 2022. Note that in some cases, after a state was reviewed by CCHP, it is possible that the state may have passed a significant piece of legislation or implemented an administrative policy change that CCHP may not have captured. In those instances, the changes will be reviewed and catalogued in the upcoming Spring 2023 edition of CCHP’s Summary Report. As in previous editions, information in the policy finder remains organized into three categories: Medicaid reimbursement, private payer laws and professional requirements. Additionally, for this edition, CCHP received support from the National Association of Community Health Centers (NACHC) through funding from the Health Resources and Services Administration (HRSA) to create a specific category on federally qualified health center (FQHC) Medicaid fee-for-service policies. FQHCs have many unique rules that apply to them that sometimes effect their ability to utilize telehealth, such as the definition of a visit/encounter in the Medicaid program. The new FQHC category takes these considerations into account and will help FQHCs be able to more easily navigate to the policies that specifically affect them.
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Federal Public Health Emergency Considerations |
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With the passage of HR 2617 (Federal Omnibus Bill), On December 23 rd, the House of Representatives approved a $1.7 trillion spending package; Included in the legislation were a number of changes that have the potential to impact telehealth providers across the nation.
HR 2617 includes several provisions impacting telehealth, including extending some of the telehealth COVID-19 telehealth flexibilities. In the budget bill passed for FY 2022, Congress had included a 151-day extension after the end of the public health emergency (PHE) for some COVID-19 telehealth flexibilities. However, with the passage of HR 2617, these flexibilities will now last until December 31, 2024. The main telehealth provisions in the bill include:
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For Medicare:Some telehealth flexibilities in Medicare are extended to December 31, 2024. These flexibilities include:
- temporary suspension of the geographic site requirement,
- continuing to allow the home as an eligible originating site,
- allowing certain providers, including FQHCs and RHCs to continue to be eligible telehealth providers during this period,
- delaying the in-person mental health visit requirement for services that take place when the patient is not in a geographically eligible location or at home that is found in non-pandemic telehealth policies, and
- continuing to allow audio-only to be used to provide some services.
- A study on telehealth and Medicare program integrity that will include a medical record review of claims from January 1, 2022 to December 31, 2024. Elements to be examined include the types of services furnished, where they were furnished, and duration of services.
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For the VA:Development of a strategic plan to ensure effectiveness of telehealth delivered by the VA to their enrollees.
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Other Items:Extension of safe harbor for absence of deductible for telehealth in health savings accounts for another 2 years (for plans after December 31, 2022 and before January 1, 2025).
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NEW Telemedicine for Physical Exams Video Now Live!
Collaboratively developed by the NETRC and colleagues at MaineHealth, this training demonstrates best practices, including:
• General tips and tricks, such as using in-home devices, having a helper, and other “rooming” considerations
• Best practices for working with an interpreter
• Head, Eyes, Ears, Nose, and Throat exam
• Respiratory, Cardiovascular, Abdominal, Neurologic, Skin, Musculoskeletal, and Psychiatric exams
• Exam documentation
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TelehealthLocator Data Collection Still Open!
We are excited to share that the development of a new public facing tool, TelehealthLocator, is underway! TelehealthLocator will provide a single point of access to view and overlay gaps in access to care, broadband, and telehealth availability by service type. WIM Tracking, in collaboration with the TelehealthLocator TRCs, is working to determine what telehealth services are offered across a 24-state and 6 territory region, including the NETRC region.
We'd appreciate your assistance! Follow this link to complete an online form to identify the services your facility offers in-person and via telehealth. You will be updated when the information you provide is available in the tool.
Please contact a NETRC staffer or WIM Tracking directly with questions at the contact information below
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NEW RESOURCE: Vermont Emergency Department TelePsychiatry Needs Assessment |
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The report, the Vermont Emergency Telepsychiatry Network Needs Assessment 2022, was supported by a grant from the Mental Health & Suicide Prevention initiative of the VT COVID-19 Response Fund of The Vermont Community Foundation.
Vermonters of all ages are presenting to EDs with mental health needs and waiting days before they can get admitted to psychiatric inpatient care or discharged. EDs throughout the US are experiencing similar problems, and some have implemented telepsychiatry to meet the needs of the community.
This needs assessment bridges the gap between a basic understanding that more telepsychiatry services are needed in Vermont EDs and a specific understanding of what form those services should take, who would be served, what resources would be needed, and who could guide the process.
The Vermont Emergency Telepsychiatry Network (VETN) has been formed to develop a statewide system helping Vermont EDs provide timely psychiatric assessment and treatment via telehealth for individuals with mental health needs. There is much work to be done. The VETN Advisory Board is in the process of following the six recommendations listed in this report.
If you would like to join our collaborative effort, or simply stay informed, please visit reach out to project lead Ali Johnson, MBA ( alij@vpqhc.org). |
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Upcoming Webinars and Events |
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Join Project ECHO: Aging, Community, and Equity to learn about the impact of the pandemic on the mental and physical well-being of older adults living in rural communities and share potential solutions. There is no cost to participate. Please see the flyer for additional information.
Intended audience:
- Medical, behavioral, and social service providers
- Nursing facility, home health, home care, and hospice
- Transportation and other community-based organizations
- Any other individuals or groups across the long-term care continuum
Time: 2nd Wednesday of every month 12:30pm-2:00pm EST (January 2023 – October 2023)
The project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $475,000 annually with 100% funded by HRSA/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, HRSA/HHS or the U.S. Government.
This project is funded by HRSA and is brought to you by CARE2, a collaboration between Medical Care Development and University of New Hampshire Institute for Health Policy and Practice.
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AI Sweeping Healthcare - The Benefits of Smarter Patient Engagement
January 24, 2023 1:00PM ET
At the start of the COVID pandemic, many segments of the healthcare industry rushed to digitally transform their virtual care, providing integrated video interfaces for doctors and therapists that are now a standard part of patient care.
Now, in the post-pandemic economy, patient and consumer behavior and expectations are continuing to change, and businesses need to expand their digital transformation initiatives to meet these expectations. Organizations across all sectors of healthcare face increased competitive and regulatory pressure to improve patient experiences, while also improving healthcare efficiency to tackle today’s economic challenges and medical staff shortages.
What’s the solution? Smart AI-driven technology that can elevate and enrich patient engagement, while improving healthcare workflows.
Please join us for our special webinar, “AI Sweeping Healthcare - The Benefits of Smarter Patient Engagement”, where Vonage leaders will provide informed views on the AI and digital technologies that are now being applied across patient and consumer journeys. Vonage provides Communications APIs - software building blocks - to tens of thousands of global organizations, giving Vonage a unique perspective into ongoing application innovation from emerging tech companies to the largest enterprises.
To learn more and to register click here
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How to Maximize the Value & Sustainability of Your Telehealth Investment
The sudden spike in demand for telehealth meant practices needed to quickly adapt to new workflows, technology, and training. However, this is leading many to question whether these swiftly developed telehealth programs will be sustainable in the years to come.
The benefits of telemedicine have proven to be effective in not only patient outcomes but also in patient acquisition and retention rates, all of which have an impact on the bottom line. So, to ensure sustainability, virtual care delivery models need to scale and adapt to patient’s increasing expectations for telehealth.
Join this webinar and learn:
-How Geisinger was able to do the visits of 10 clinics with the cost of 1 clinic
-How Hospital Medicine Solutions has maximized the value of a hybrid care model
-How telehealth integration into a care delivery model can deliver cost savings in the post-pandemic environment
How to streamline, consolidate and support technology solutions for telehealth
To learn more and to register click here
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Advancing Health Equity among Hispanic/Latino Populations
Learning series, in Spanish, on best practices and opportunities for action
The Health Resources and Services Administration’s (HRSA), Office of Intergovernmental and External Affairs (IEA) invites you to be part of the next round of our Advancing Health Equity Among the Hispanic/Latino Populations Spanish Learning Series.
This four-part series includes didactic portions on selected topics as well as discussions about factors that contribute to health disparities, barriers to health equity, and successful strategies and models to improve access to care and advance health equity among Hispanic/Latino populations. Participants will be able to engage with subject matter experts and potential new partners and receive information on HRSA programs and resources to support their health equity efforts.
1st Session: Getting to Know HRSA
Date: Tuesday, February 7, 2023
Time: 10:00am - 11:15am PST | 11:00am - 12:15pm MST | 12:00pm - 1:15pm CST | 1:00pm - 2:15pm EST
Session Objectives:
- Discuss HRSA programs, funding opportunities, and resources to enhance primary healthcare access and advance health equity.
- Share effective ways to collaborate and stay connected to HRSA to leverage resources and gain access to innovative and high-value programs.
To learn more and register click here
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Featured Telehealth News
A larger news compilation can be found on the NETRC site here.
Northwell Health Launches AI-Based Chatbot to Reduce Maternal Mortality
mHEALTHINTELLIGENCE January 12, 2023 Link
The New York City-based health system has released an artificial intelligence-based chatbot to identify urgent needs and extend virtual care for pregnant women.
Thousands of patients could lose mental health services if pandemic-era rules end, Talkiatry data show
FIERCEHealthcare January 12, 2023 Link
As the pandemic wanes, telepsychiatry companies are crossing their fingers that the virtual care market boosted by the pandemic can continue to thrive.
Medicare Rolls Out Telehealth Indicator for Patients to Easily Find Telehealth Providers
Telehealth.org January 12, 2023 LInk
In January 2023, the Centers for Medicare & Medicaid Services (CMS) rolled out a new telehealth “indicator” to make information about Medicare telehealth providers on publicly-available clinician profile pages more readily available.
Improving Handovers in Mental Health Emergency Telehealth
Telehealth.org January 12, 2023 Link
Emergency departments (EDs) nationwide face numerous challenges, including the demand issue of many mental health patients and few mental health professionals to serve them. Emergency telehealth services have been tested and conducted for decades, often in Medicaid telehealth and safety-net settings.
MA Health Plans to Expand Access to Virtual Behavioral Healthcare
mHEALTHINTELLIGENCE January 13, 2023 Link
Through a partnership with Valera Health, Harvard Pilgrim Health Care and Tufts Health Plan members will gain access to behavioral health services delivered through telehealth.
Telehealth utilization has declined almost 4%
HEALTHCARE FINANCE January 13, 2023 Link
The decline was larger than the national average in the South, Midwest and West, and there was an increase in the Northeast.
Audio-Only Coverage of Behavioral Health Common Across Medicaid Programs
mHEALTHINTELLIGENCE January 16, 2023 Link
Most states took at least one Medicaid-related policy action to expand coverage of telebehavioral health services in response to COVID-19, most commonly expanding audio-only coverage of the services, a new report shows. Released by Kaiser...
'TELEHEALTH SAVES TIME, TRAVEL, AND MONEY FOR PATIENTS,' CANCER RESEARCHERS FIND
Healthleaders January 17,2023 Link
Increasing the number of telehealth visits for cancer patients could reduce the financial toxicity of oncology services.
Telehealth Can Support Care of Young Children with Developmental Delay
mHEALTHINTELLIGENCE January 17, 2023 Link
A recent study found that a telehealth-delivered parenting intervention combined with real-time therapist coaching highly benefited young children with developmental delay.
UPDATING FEDERAL REGULATIONS ON SUD PAITENT RECORDS
CCHP January 17,2023 Link
Last month, the US Department of Health and Human Services (HHS) proposed regulations to change current rules regarding the protection of patient records in federally run substance use disorders (SUD) programs.
Keck Hospital and School of Medicine of USC makes powerful strides with tele-GI
HealthcareITNews January 17, 2023 Link
The pandemic spurred the health system's gastroenterologist professors, other clinicians, IT leaders and administrators to kick some very complex virtual care into high gear.
April 2023 End of the PHE? Mental Health Telehealth & Beyond
Telehealth.org January 17, 2023 Link
While the official end of the public health emergency (PHE) was extended to April 2023 for many federal government programs, two federal actions will further extend the deadline for federal Medicare reimbursement until at least December 31, 2024. A notable requirement for mental health telehealth providers to see their clients and patients in person was announced, despite telebehavioral health being permanently approved for medicare reimbursement in 2022.
Telehealth Gave Orgs Economic Boost, Cut Carbon Footprint
mHEALTHINTELLIGENCE January 18, 2023 Link
Recent research found that telehealth led to the saving of over 53 million miles in travel distance and over $22 million in travel costs.
After a big telehealth buy, Horizon Health Alliance now serves 70% of patients virtually
HealthcareITNews January 18, 2023 Link
The provider of mental health and substance use disorder care is now fully equipped and boasts high patient satisfaction.
Preparing For The End Of The PHE And The End Of HIPAA Enforcement Discretion
NCTRC Staff January 18, 2023 Link
At the start of the PHE, the HHS Office for Civil Rights (OCR) issued a Notification of Enforcement Discretion to all health care providers that are covered by HIPAA and provide telehealth services during an emergency. What it has meant is that covered health care providers would not be subject to penalties for violations of the HIPAA Privacy, Security and Breac h Notification Rules that occur in the good faith provision of telehealth during the PHE.
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Recommended Telehealth Research/Resources
Check out the complete Telehealth Library Database on the NETRC site here.
Encouraging Health Information Technology Adoption in Behavioral Health: Recommendations Report
'Red Flags' and 'Red Tape': Telehealth and pharmacy-level barriers to buprenorphine in the United States
Textor. L, et. al, 2022. Link
Evaluation of Mental Health Mobile Applications
Telehealth for Rural Areas
Telehealth.HHS.gov, 2022. Link
Telehealth for American Indian and Alaska Native Communities
Telehealth.HHS.gov, 2022. Link
Power and Participation: How Community Health Centers Address the Determinants of the Social Determinants of Health
Cole M., Jolliffe M, Gottlieb B., MassGeneral Brigham Hospital, 2022. Link
Considerations for Fostering an Antiracist and Equitable Telehealth Enviornment
American Academy of Pediatrics, 2022. Link
Telehealth and Substance Use Disorder Services in the Era of COVID-19: Review and Recommendations
Office of National Drug Control and Policy, 2022. Link
HHS Guidance on HIPAA and Audio-Only Telehealth
US Health and Human Services, US Office of Civil Rights, 2022. Link
TTAC 2022 Telehealth Technology Survey Results
National Telehealth Technology Assessment Resource Center, 2022. Link
USDA Rural Placemaking Digital Toolkit
USDA, University of Kentucky, 2022. Link
Billing for Telehealth Encounters: An Introductory Guide on Medicare Fee-For-Service
Center for Connected Health Policy, 2022. Link
Addressing Virtual Care Disparities for Patients with Limited English Proficiency Digital Inclusion as Health Care- Supporting Health Care Equity with Digital Infrastructure Initiatives
Rodriguez, J.A., Shachar, C., Bates, D.W., 2022. Link
Consumer Experience Trends in Healthcare 2021
Addressing Virtual Care Disparities for Patients with Limited English Proficiency
Tan-McGrory, A. Schwamm, L., et. al. 2022. Link
Remote Monitoring of Patient- and Family-Generated Health Data in Pediatrics
Foster, C., Schinasi, D, et. al. 2022. Link
NETRC Regional Telehealth Legislation and Regulation Tracker- Center for Connected Health Policy, 2022 Link
University of New Hampshire TelePractice Center (TPC) TelePractice Training Videos- UNH TPC 2021 Link
FQHC Telehealth Playbook- MA FQHC Telehealth Consortium; 2021 Link
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The Northeast Telehealth Resource Center has been made possible by grant numbers G22RH30352 and 1 U1UTH42523‐01‐00 from the Office for the Advancement of Telehealth: HRSA / DHHS. |
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