Lawmakers tee up telemedicine priorities

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With help from Arthur Allen (@arthurallen202) and Darius Tahir (@dariustahir)

UP NEXT IN CONGRESS — EXPANDING TELEMEDICINE REIMBURSEMENT: In the weeks leading up to the 116th Congress, lawmakers are laying out general plans for expanding telemedicine payments. A few, along with CMS Administrator Seema Verma, dropped by a virtual-care themed symposium hosted by lobbying group the Alliance for Connected Care. Here are a few of our takeaways:

— Rep. Bill Johnson said he plans to advance legislation co-sponsored with Rep. Doris Matsui that could remove geographic and site restrictions on reimbursement for all Medicare codes. A version of that bill passed as part of the opioid package, but it only waives restrictions for care related to substance use disorder.

“The providers want it, the technology is there,” Johnson said, noting that the major barriers to widespread telehealth access are physician licensing and reimbursement. “There is absolutely no reason why in Timbuktu, rural Appalachia, you can’t get access to a world-class heart surgeon over telehealth.”

Johnson— a member of House Energy and Commerce who’s also part of the Congressional Telehealth Caucus—plans to examine broadband coverage next session, he said. He said he was encouraged by FCC Commissioner Brendan Carr’s Connected Care pilot program, a nascent concept for a fund that could support remote monitoring programs in rural areas.

— Rep. Anna Eshoo said Washington decision makers should focus on shrinking the gap between telemedicine coverage on Medicare Advantage plans and the original fee-for-service model.

Eshoo, a member of Energy and Commerce’s telecommunications subcommittee, also plans to work on increasing broadband connectivity; she introduced a bill this year mandating that broadband conduit pipes should be laid on roads and highways built on federal lands as they’re being built.

She noted that telemedicine advocates on Energy and Commerce who represent rural districts across the country will have “real opportunities on both sides of the aisle.”

— Sen. Roger Wicker, a member of the Commerce Committee and its telecommunications subcommittee, also plans to prioritize broadband deployment. Last year he introduced the SPEED Act, which would expedite the permitting for that process, along with Sen. Catherine Cortez Masto, though the measure stalled in the Committee on Environment and Public Works.

eHealth Tweet threadof the day: Austin Frakt @afrakt This has never happened to me before. I emailed an author of a paper for background/comment. No reply. I emailed a different author of that paper. Also no reply. Not saying people have to respond, but not doing so is a great way to make sure nobody knows about you/your paper.

This doesn’t bother me as “something of a journalist”. It bothers me as a researcher who cares about dissemination. It’s a case study in how not to do it, again unless your goal is obscurity (which is fine, it just doesn’t scale well ... for the community).

By which I mean, we, as a community, have to be communicating what research is about/for if we expect funding and support.

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... Back at the Alliance for Connected Care, Verma said her agency is thinking of ways to accommodate a large and very tech savvy population of senior citizens; expanding coverage of virtual check-ins is just one such strategy. She noted that she tested out a driverless car on a recent trip to California, which got her thinking about how automation could play into the delivery of care. “As we’re serving older individuals, disabled individuals...the technology that wasn’t designed for them specifically could be applied.”

Smartwatches might be part of that ecosystem too; she mused that her husband’s cardiac arrest in the Philadelphia airport last year could have been prevented or predicted with a smartwatch passively measuring pulses.

She also said that CMS was planning new features for its eMedicare program, an online system designed to guide beneficiaries through the selection process.

REPORT: TRUMP ADMINISTRATION’S PLANS FOR VA PRIVATIZATION: The Trump administration is intent on elevating private sector health options for veterans, Pro Publica’s Isaac Arnsdorf reports. In January, Trump’s team plans to unveil a proposal that could further push veterans to see private doctors.

Privatization has been a touchy topic for VA officials; in a New York Times op-ed published the week he was fired, former VA Secretary David Shulkin said the Trump administration saw him as an “obstacle to privatization who had to be removed.”

BROADBAND LEADERSHIP UPDATES: Wicker, who has said he wants to take over the full Senate Commerce Committee, could decide to put Sen. John Thune in charge of the telecommunications subcommittee, our POLITICO colleague John Hendel reports.

Thune told POLITICO earlier this week that he was deciding between making a bid for the telecom panel or the Commerce surface transportation subcommittee, saying “both are of great interest to me.”

The decision to go with telecom means that Thune — who will step down as chairman of the full Commerce Committee next year after being elected GOP whip — will likely stay involved in debates ranging from 5G wireless to data privacy to rules governing the media marketplace.

One factor driving Thune’s telecom interest is the upcoming process to reauthorize satellite TV legislation, which is set to expire at the end of 2019. That process, which typically happens every five years, has been viewed as must-pass legislation, although the broadcast industry is lobbying Congress to let the statute expire.

... Over at the FCC, Chairman Ajit Pai said today he intends to stay on as head of the agency as newly empowered House Democrats pledge rigorous oversight of his leadership, our colleague Margaret Harding McGill reports. In October, ahead of the midterm elections, Pai sidestepped a question about his future when asked what he would do if Democrats won the House.

AMIA URGES TRUMP ADMINISTRATION TO ALIGN HEALTH AND CONSUMER PRIVACY: The American Medical Informatics Association says Washington officials should “harmonize” data privacy policies within the health and consumer sectors. In response to a request from information from the National Telecommunications and Information Administration on protecting consumer privacy, AMIA pointed out that varying interpretations of HIPAA have led to confusion, and that some health-related technologies actually fall outside the patchwork of HIPAA, Federal Trade Commission regulations and state laws. “[T]he administration should consider developing an ethical framework around the collection, use, storage, and disclosure of the personal information consumers may provide to organizations,” they wrote.

ICYMI — AI AND OUTCOME PREDICTION: A CMS effort to get data scientists talking about how artificial intelligence can help predict clinical outcomes and aid new quality measures appears to be underway. Verma hinted at that effort at the Health Care Payment Learning and Action Network summit earlier this year (skip to the 4:58 mark.)

— NPR reportson Nebula Genetics, which could pay patients for their genetic sequence data

— MedCityNews reports on CloudMine’s bankruptcy