Telehealth roundup

With help from Arthur Allen (@arthurallen202), Darius Tahir (@dariustahir) and Joanne Kenen (@joannekenen)

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House Ways and Means is expected to mark up a series of drug pricing bills this week, and Sen. Marsha Blackburn is expected to revive her privacy legislation in the Senate. Here’s what else we’re tracking:

—Telehealth roundup: Still more comments on that Congressional Telehealth Caucus RFI, and CMS finalizes its Medicare Advantage proposal.

—New push for AI in radiology: NVIDIA and the American College of Radiology are trying to make AI software more accessible to clinicians, even if they have no programming experience.

— 23andMe responds to study on BRCA misses: A study led by researchers from genetic information company Invitae finds that 23andMe’s direct-to-consumer test misses 90 percent of BRCA mutation carriers; a 23andMe spokesperson called the research “highly misleading.”

eHealth Tweetof the day: Ashish K. Jha @ashishkjha Crowdsourcing for a talk: Those of you who think about and work on patient safety: If you could wish for one thing that providers, organizational leaders or policymakers could do to improve patient safety, what would it be? One thing. Please RT

Priscilla Novak, PhD @priscillanovak Replying to @ashishkjha I’m torn between wishing for an EHR that is intuitive to use, having enough nurses to care for patients or better facility design that eases the burdens of physicians

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AGING SERVICES GROUP TO CONGRESS: DON’T FORGET ABOUT ELDERCARE— The aging services provider association LeadingAge wants lawmakers crafting comprehensive telehealth legislation to keep older patients in mind, and to waive certain Medicare requirements to make the technology more accessible.

In its response to the Congressional Telehealth Caucus’ request for information, LeadingAge urged Congress to mandate testing new care models for nursing facilities. One demonstration LeadingAge described would test out telemedicine and remote monitoring technology in their patients’ homes, independent living centers, affordable housing and other home-based settings. “Providers could bill for services such as: monitoring, educating, triaging and managing participants’ health,” the group wrote. Another demonstration could examine whether it makes sense to offer financial incentives to skilled nursing facilities. Read the rest of their comments here.

... Also on telehealth, CMS on Fridayfinalized updates to its policy on telehealth benefits in Medicare Advantage plans. Under the new rule, private Medicare plans that serve about a third of all Medicare beneficiaries can include additional telehealth benefits starting in 2020.

It’s a change that CMS says will encourage greater adoption of telemedicine. Medicare Advantage plans could already offer telehealth services as a supplemental benefit, but the final rule says telemedicine can be a basic benefit. That provision was mandated in the 2018 Bipartisan Budge Act.

Starting this year, beneficiaries in traditional Medicare can get coverage for virtual check-ins, while in the past they could only get coverage if they lived in rural areas.

As part of the same final rule, CMS updated its Star Ratings system for Medicare Advantage and Part D plan quality, including for plans affected by uncontrollable events such as hurricanes. Pros can read the story here.

...Elsewhere at CMS, HHS inspector general Daniel Levinson told Democratic lawmakers that his office is probing CMS’ communications contracts with GOP-linked firms following a POLITICO report, according to our colleagues Dan Diamond and Adam Cancryn, who authored that report.

In a letter to Rep. Frank Pallone (D-N.J.), who chairs the House Energy and Commerce Committee, Levinson said the OIG has already “taken preliminary steps to look into the matter.”

Adam and Dan found that CMS had spent millions of dollars on the communications contracts, including one with a longtime GOP media adviser whose ask was to raise Administrator Seema Verma’s profile.

The OIG’s review would examine whether Verma had steered those contracts, which the Trump administration suspended last week.

This news comes shortly after Levinson announced his resignation; this probe could eventually be overseen by a new inspector general, after he departs on May 31.

NVIDIA AND AMERICAN COLLEGE OF RADIOLOGY PARTNER ON AI—Computing technology company NVIDIA and the American College of Radiology are partnering to make widely available an AI toolkit that radiologists can use to build, train and share diagnostic algorithms, the two groups announced today.

ACR plans to make NVIDIA’s software toolkit available through its own software platform for radiologists. The two groups did a pilot at The Ohio State University to better understand how to share AI models without also transferring sensitive patient data.

The system could help clinicians without programming experience tap into AI, Keith Dreyer, chief data science officer at Partners Healthcare, said in a news release. And while algorithms generally work best at the site where they were trained, “limited training sets are not always representative of the population at large,” he said. Allowing clinicians to train them at a diverse set of sites “helps ensure resiliency while reducing algorithm bias.”

23ANDME RESPONDS AFTER GETTING DINGED ON BRCA TEST—Last week, researchers from genetic information company Invitae — which plansto offer its own personal genetic test —presented a study finding that 23andMe misses almost 90 percent of carriers of a BRCA breast cancer mutation. A 23andMe spokesperson tells Morning eHealth that research was “highly misleading.”

GenomeWeb reports that researchers from Invitae presented the study at the annual meeting of the American College of Medical Genetics and Genomics. Invitae clinical geneticist Edward Esplin said the study found that 23andMe’s direct-to-consumer BRCA test, designed to detect variants in the BRCA1 and BRCA2 genes, actually misses the majority of carriers.

…”We are very clear with customers that our BRCA1/BRCA2 (Selected Variants) report only tests for three out of thousands of possible genetic variants,” the spokesperson said, pointing to a warning 23andMe issues at the top of reports.

NEW EHR STUDIES—One new studyin JAMIA finds that the second stage of CMS’ Meaningful Use incentive program likely contributes to an increase in the use of patient portals; anotherfinds that EHR downtime has no impact on 30-day patient mortality.

TRANSPARENCY HAS ITS LIMITS -Brandeis University’s Stuart Altman, who for decades has watched bright health care ideas come and go, and who is also the chair of the Massachusetts Health Policy Commission, isn’t all that impressed with the Trump administration’s proposal for making hospital prices transparent. He’s not against transparency—he said no economist can be — but it’s not magic.

“Much of this is rhetoric and pure nonsense,” he said at an event on health care costs sponsored jointly by POLITICO and The Forum at the Harvard T.H. Chan School of Public Health. Patients sometimes see a higher price and decide that means better care, and that they want to go there.

If the proposal involves just posting prices, as the Trump administration is currently putting forth, “I don’t want to say it’s useless – but it’s useless,” he said. He added that the Trump administration isn’t the only one coming up with such proposals.

At the same event, Katherine Baicker, dean of the Harris School of Policy at the University of Chicago, pointed out that patients don’t always trust transparency. If it comes from an insurance company, the patient may just fear he or she is being pushed into care that’s cheaper, but also inferior. Watch the whole program moderated by POLITICO’s Joanne Kenen here.

GOTTLIEB’S LEGACY—Former FDA Commissioner Scott Gottlieb said goodbye to the agency last week; though he took action against teen vaping and advocated for updated health technology, his “lasting mark might be the style he used to sell a surprisingly up-tempo regulatory agenda,” our colleague Sarah Owermohle writes.

“One of the Dr. Gottlieb’s most enduring legacies may be that he made it safe for conservatives to love the FDA,” Steven Grossman, deputy executive director of the Alliance for a Stronger FDA, old POLITICO. Pros can read the rest of the story here.

—Sara Merken writes for Bloomberg Law about states establishing cyber requirements for insurers.
—Stephanie Goldberg writes about Allscripts’ attempts to diversify for Crain’s Chicago Business