Telemedicine could advance in spending deal
With help from Arthur Allen (@athurallen202) and Darius Tahir (@DariusTahir)
GOVERNMENT OPENS, TELEMEDICINE ADVANCES IN SPENDING DEAL: Provisions that would expand Medicare coverage for telemedicine services appear in both the House and Senate versions of a federal spending bill that lawmakers passed this morning after late night/early morning drama and a few-hour shutdown. The CHRONIC Care Act would also expand remote coverage for chronic care management for Medicare Advantage enrollees, renal failure and stroke victims.
The package also contains a sort-of-health-IT measure that emerged in 2011 from the House Ways and Means Committee, the “Standard Data and Technology Advancement Act,” which sets requirements for the electronic content and format of data used in the administration of various HHS programs including the Temporary Assistance for Needy Families, child care, foster care and Supplemental Security Income programs. The standardization is supposed to make the programs work more smoothly and ease communication among their administrators.
The budget agreement also provides at least $2 billion for the NIH over two years and $6 billion to address the opioid abuse epidemic. Advocates, including Research!America support those measures, but are disappointed in provisions that would cut the Public Health and Prevention Fund, which supports immunizations, screenings, and research.
“We urge Congress to allocate sufficient funds to federal science, public health and R&D agencies in FY18 and FY19 to ensure medical progress and innovation advances at the level of scientific discovery,” Research!America President and CEO Mary Woolley said in a statement.
MED STUDENTS CAN NOW UPDATE EHRS WITHOUT PHYSICIAN RE-DOCUMENTATION: A change in CMS code lets teaching physicians avoid having to re-document changes that their medical students make to patient records. CMS’ previous Evaluation and Management code documentation required physicians to formally rewrite any updates students made as part of a billable service to patient records, but under the new code, they can simply verify all student documentation including patient history, physical exams and medical decisions.
Students must still perform any examinations in the physical presence of a teaching physician or resident, and the teaching physician is then required to perform or re-perform those exams to ensure they’re accurate, but they don’t have to fully re-document updates to the records. The change could help students participate in the hospital’s workflow, and better learn how to use EHRs, without creating administrative burdens for physicians, according to the American College of Physicians. “This change allows teaching physicians to provide a meaningful educational experience for the student within a much more streamlined workflow,” Jack Ende, ACP’s president, said in a statement. ACP advocated for the change to CMS.
CMS made the change after seeking comment from stakeholders about whether evaluation and management codes were working for the; some guidelines had not been updated to account for new technological developments, especially EHR use, according to the agency. CMS plans to continue looking into new potential revisions that could reduce clinical burden, a spokesperson told POLITICO. More for Pros here.
ROE SEEKS REELECTION: We linked to a report earlier this week that Rep. Phil Roe was considering joining several GOP leaders opting not to run again in 2018. It seems, however, that he’s made up his mind to run for a sixth term in 2018, Roll Call reports. Roe, who chairs the Veterans Affairs committee, has criticized the VA’s efforts to buy an EHR system from Cerner that would link up to the military’s installation. He said he was grateful that VA Secretary David Shulkin had put a hold on those plans, and has advocated for better oversight throughout the development and deployment process. More on that project for Pros here.
eHealth Tweet of the day, in which the Superbowl creates an opportunity for virtual care: Jefferson Health @TJUHospital: “During the #EaglesParade our #UrgentCare locations are available, as well as #JeffConnect, the telehealth option that has an on demand component which allows patients to have a video visit w an emergency medicine physician via a mobile device or computer: http://bit.ly/2C4xbcD .”
It’s FRIDAY at Morning eHealth, where your author just learned that “the lobster shift” is an old-school journalism term for working the overnight. Send your best examples of bygone news jargon, crustacean or otherwise, to [email protected]. Tweet news tips to @ravindranize, @athurallen202, @DariusTahir, @POLITICOPro, @Morning_eHealth.
LAWMAKERS URGE AZAR TO PROMOTE TELEHEALTH: In a letter to newly appointed HHS secretary Alex Azar and CMS administrator Seema Verma, a group of Representatives argued that the “sound implementation” of MACRA could create better opportunities for health care at a distance. “[C]urrent regulatory restraints often discourage adoption of these technologies,” despite the fact that CMS is “statutorily authorized to remove some of these barriers to adoption and expand the use of telehealth and [remote monitoring] services,” they wrote. The group — which included Reps. Doris Matsui, Bill Johnson, Gregg Harper, Ben Ray Luján and Marsha Blackburn — said CMS could use its authority to clarify when telehealth and remote monitoring could be used under the merit-based incentive payment system, known as MIPS, among other steps.
EHRA SKEPTICAL ON FDA DIGITAL HEALTH GUIDANCE: The Electronic Health Record Association, a trade group for EHR vendors, is none too pleased with FDA’s recent digital health guidance. The agency’s write-ups included a set of guardrails for how the agency will regulate clinical decision support software (CDS) — a document the industry had waited seven years for.
The EHRA, however, was far from mollified by the CDS and other guidances, which they declared to be out of sync. EHRA agrees with the CDS Coalition that the agency hasn’t used a risk-based approach to the genre of software.
The CDS guidance specifically falls short in “the absence of clear and unambiguous direction for software developers,” the letter declares.
AETNA SUES OVER HIV PRIVACY BREACH: Insurance giant Aetna is suing a company for sending letters to patients clearly displaying their HIV status, FierceHealthIT reports. Aetna had contracted Kurtzman Carson Consultants, a claims administrator, to send letters to 12,000 of its customers about a settlement over HIV medication policy. The letters were sent in envelopes with a see-through window so that anyone handling the mail could see that the correspondence was about the recipient’s HIV medications. Aetna settled its own class-action lawsuit over the breach for $17 million, and wants at least $20 million in damages from Kurtzman Carson.
NICE WORK: Leidos’ has cleared the renewal of its contract to maintain the military’s current EHR, the Armed Forces Health Longitudinal Technology Application, or AHLTA, while it oversees AHLTA’s replacement by a Cerner system. The Defense Health Agency will pay Leidos $25 million for the first year starting March 1, after a protest by competitor CSRA was dismissed this week.
WHAT WE’RE CLICKING ON
— A new drug recovery app uses cryptocurrency for incentives
— Google’s bid to reduce health care costs: invest in artificial intelligence
— The patient who used a supercomputer to monitor his own organs
— Study says health apps often neglect user privacy
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