In Clearing the Way for Telemedicine, the FCC’s Intergovernmental Advisory Committee (IAC) members identify state, local, Tribal, and territorial regulatory barriers to the use of telemedicine, as well as incentives that promote the adoption of telemedicine. The report discusses key issues, including state and local licensing laws or regulations that prevent telehealth providers from treating patients across state lines, and intrastate restrictions that may inhibit the provision of telemedicine.
Minnesota gets a nod for being one of three states that have specific laws that require that payers pay the same amount for a Telehealth delivered service as would have been paid had the service been provided in-person.
Here are their recommendations looking at issues or broadband access, regulatory barriers and digital equity and digital integration issues:
- Broadband needs to be funded. FCC initiatives such as the recent Connected Care NPRM and the Rural Digital Opportunity Fund can support bringing Telehealth services directly to low-income patients and patients in underserved, rural, Tribal, and territorial areas
- Coordination needs to be improved between state and federal universal service programs aimed at expanding broadband to avoid having different programs supporting service availability in the same area and to ensure that support goes to areas without broadband service and without the likelihood of receiving it in the foreseeable future.
- Broadband Telehealth services should be independent of the technology used to provide such service, particularly in rural areas. Creative ways of deploying hybrid fiber along with wireless, satellite, and TV white spaces offer different advantages and opportunities.
- The term “Telehealth” should be construed broadly, and should incorporate the need for software, equipment, data storage and patient record access along with the various spectrum and telecommunications solutions and broadband deployment.
- Telehealth policy should address the deployment of necessary infrastructure, including homes of older adults, and provider offices in rural and frontier communities that are far from a hospital.
- Improved geographic data should include the types of services that are available in various locations.
- Providers must ensure that any equipment they purchase is interoperable and meets industry standards and can be used to connect to multiple Telemedicine platforms.
- Data and documents should be able to be transferred in multiple formats and structures in order to be operable in the various application programming interfaces (APIs), rather than in the prevailing “PDF” format, to allow electronic transfer with full interoperability and use of the underlying data elements.
- To be considered interoperable, software vendors should be required to open their systems to communicate electronically patient information.
- The FCC Rural Health Care Program (RHCP) program should expand eligible equipment and services to cover institutional mobile technologies that are not currently covered under the program. Mobile telephones and service should be an eligible cost item of the RHCP. 28
- The FCC should reach out to relevant federal agencies to address reimbursement disparities for services categorized as “Telemedicine,” whether in Medicare or other medical services.
- Telehealth, almost by definition, is a geographically dispersed, often interstate service. The complexities of interstate licensing, credentialing and privileging should be revised and simplified to allow for virtual multi-state service.
- Malpractice insurance coverage should cover Telehealth delivered services and should extend into other states in which Telehealth services are being offered.
- Health benefit plans should not exclude from coverage a covered health care service or procedure delivered by a preferred or contracted health professional to a covered patient as a Telemedicine medical service or a Telehealth service solely because the covered health care service or procedure is not provided through an in-person consultation.
- The FCC should work with other governmental agencies to ensure that the same standard of care and other measurements should be applied to both in-person and virtual visits.
- HIPPA and other privacy rules should be revised to allow patients to share Telehealth information with Telehealth providers and for treating Telehealth providers to share that information with each other.
- The FCC should encourage legislation or regulations that detail how and in what manner Telehealth can be used to establish a patient-provider relationship and when it can be used for prescribing medicine, particularly controlled substances. C.
- The public, state, local, Tribal, and territorial governments and health care providers all need to be aware of the technologies and services available for Telehealth.
- Telehealth considerations and the infrastructure to provide health services virtually should be integrated into all state, local Tribal and territorial emergency planning.