Pandemic surveillance irks Congress

With help from Darius Tahir (@dariustahir) and Cristiano Lima (@viacristiano)

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Quick Fix

— Pandemic surveillance irks Washington: Sen. Michael Bennet has questions for HHS officials on data collection, and Senate Commerce Republicans plan to introduce a privacy-themed bill soon.

— HIPAA noncompliance drops: Ciitizen’s latest right-to-access benchmark shows providers making progress in following the health information law.

— Medicare to pay for some phone calls: CMS heeded provider groups’ calls to waive video requirements for some telehealth visits, but they say there’s more to be done.

eHealth tweet of the day: Matt Flegenheimer (@mattfleg) “Deeply unsettled by the realization that Amy Klobuchar and Pete Buttigieg ended their 2020 bids *last month* and not 14 years ago as I’d ballparked.”

It’s FRIDAY at Morning eHealth where your author impulse-bought a cheap guitar and taught herself a few chords. Send tips and very simple quarantine jams (music, not preserved fruit) to [email protected]. Tweet the team at @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

Given the unprecedented public health challenge confronting regulatory affairs teams, the AgencyIQ leadership team has decided to pull research and analysis content concerning the virus and its regulatory implications in front of the paywall. It is available here: https://agencyiq.com/covid-19-resource-center/

Driving the Day

FIRST IN MORNING eHEALTH: BENNET PRESSES CDC ON PRIVACY— Citing reports of intrusive technology used to surveil patients for potential coronavirus spread, Colorado Sen. Michael Bennet is pressing CDC director Robert Redfield — along with HHS Secretary Alex Azar and White House chief of staff Mark Meadows — on the need to adhere to high privacy standards when tracing contacts.

Bennet says data collection should have a sunset date and collected data should be deleted or de-identified after the public health emergency passes; that only the minimum necessary amount of data should be collected; that Americans be given the ability to opt in to data collection; and that data be confined to CDC’s use, among other principles.

‘[E]ffective public health surveillance ultimately requires the cooperation and trust of individuals and communities whose data must be collected,” Bennet wrote. “If people fear the government will misuse their data, they may avoid testing and withhold critical information, jeopardizing our response to the pandemic and endangering the health of our communities.”

Bennet’s letter follows a bubbling public debate on medical privacy issues amid the coronavirus crisis, as we’ve previously covered.

WHAT’S NEXT FOR THAT GOP-LED COVID-19 PRIVACY BILL? — Senate Commerce Republicans on Thursday announced plans to introduce an online privacy bill targeting companies that are collecting personal information to track the spread of Covid-19, as Cristiano reported for Pros, a move that brought some new life to the committee’s stalled efforts to advance data protection rules. Sen. Marsha Blackburn of Tennessee, one of the lawmakers behind the push, said she expects the legislation to be introduced as early as next week and for it to move forward separately from another potential coronavirus relief package.

— “I think at first we’re going to have to do this as a standalone and probably move forward with a hearing and a review for it,” she told Cristiano during an interview Thursday. Commerce Committee spokespeople did not offer comment on a timeline for introduction. Blackburn said the virus has made privacy an even more pressing issue. “What you have seen with Covid-19 is that it has brought the issue to the forefront because people are incredibly concerned about what will happen with their data,” she said.

— But will the bill be bipartisan? The Tennessee lawmaker, who has introduced one of the chamber’s bipartisan online privacy bills, said she has yet to discuss the proposal with her Democratic colleagues. Sen. Richard Blumenthal of Connecticut, a top Democratic privacy hawk on Commerce, said in a statement that Covid-19 “has made urgently clear the need for strong, reliable protections” for privacy and security, adding that he looks “forward to working with colleagues on bipartisan consumer privacy protections — including eventually a national framework that secures these crucial rights.”

— One early review is in: Public Knowledge is not a fan of the plan. “This bill provides little protection for Americans’ privacy during the COVID-19 epidemic,” said Sara Collins, the consumer group’s policy counsel. “Companies may still profit from selling health information or geolocation data, and are allowed to infer who has been diagnosed with the novel coronavirus.”

CALIFORNIA CASE STUDY — A California lawmaker is warning Gov. Gavin Newsom to protect consumer privacy as the state works with tech companies to combat the coronavirus, our Katy Murphy reports.

In a letter to Newsom this week, state Sen. Hannah-Beth Jackson called for transparency about data collection and use.

“During this time of crisis, the health and safety of Californians is of paramount importance, and quick, decisive, and innovative action is necessary,” Jackson wrote. “However, such action should not be incompatible with our right to privacy.” She added that people must “safeguard our fundamental rights” rather than “sacrifice them in the name of safety.”

California has a testing partnership with OptumServe and Verily, a health subsidiary of Alphabet. Newsom has also signaled the state is considering contact tracing partnerships using technology but hasn’t shared details.

CIITIZEN RELEASES HIPAA SCORECARD 3.0 — Data from Ciitizen suggests the nation’s providers are doing better with HIPAA right-to-access compliance. The startup, which released the third version of its HIPAA scorecard in less than a year, said that the percentage of providers who were non-compliant with the rule’s access requirements dropped from 51 percent to 27 percent. The proportion of providers giving seamless access to records went from 40 percent to 67 percent, the group said.

The scorecard debuted with a big public splash last August, which was followed by rare if not unprecedented enforcement action by the Office for Civil Rights against an access offender.

MEDICARE TO COVER SOME PHONE VISITS, TELETHERAPY — Congress and provider groups pushing CMS to pay the same rate for phone calls as in-person visits scored a victory this week when CMS announced plans to raise rates for phone calls, and waive video requirements, for some evaluation and management visits. Lawmakers — including a bipartisan group of 27 senators — had called for the change as recently as this week.

Sens. Joe Manchin and Shelley Moore Capito were among the first to applaud the decision Thursday. “In West Virginia and rural areas across America, many people do not have access to reliable broadband,” Manchin told Morning eHealth, noting that the change “ensures that our healthcare professionals are reimbursed fairly for their hard work.”

… Physical and occupational therapists, as well as speech language pathologists, can also now bill CMS for virtual visits. House lawmakers had introduced a bill last week calling for those therapists’ inclusion; CMS made the change using its emergency authority during the pandemic.

Mental health providers also won out. CMS waived the video requirement for some behavioral visits and patient educations services. As we reported, the requirement that visits have both audio and visual components has been a major stumbling block for providers who have patients without broadband access, data plans or smartphones.

... In the future, CMS plans to add additional telehealth services to its coverage list using a sub-regulatory process during the pandemic, instead of its normal rulemaking process. It will also take into account requests from practitioners, according to a news release.

TELADOC EXPECTS MASSIVE GROWTH — The telemedicine giant has seen 2 million visits in the first quarter of the year, up 92 percent compared to last year, FierceHealthcare reports. The company expects between 8 million and 9 million visits in 2020, compared to a total of 4.1 million in 2019.

Another telehealth tidbit: Republican and Democratic lawmakers have bought and sold stocks hundreds of times throughout the coronavirus pandemic, including in telemedicine companies, our colleague Alice Miranda Ollstein reports. A new analysis by the Campaign Legal Center found that 12 senators made a combined 127 purchases or sales, while 37 House members made at least 1,358 transactions.

A NOTE ON LICENSING — The ERISA Industry Committee is pressing 21 state governors to join the Interstate Medical Licensure Commission Compact so that practitioners can undergo an expedited application process for state licenses. The group sent letters this week to the governors of Alaska, Arkansas, California, Connecticut, Delaware, Florida, Hawaii, Indiana, Louisiana, Massachusetts, Missouri, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Rhode Island, South Carolina, Texas, and Virginia.

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What We're Reading

—MIT Technology Review’s Will Douglas Heaven reports on the pitfalls of deploying Google’s AI in real life.
—It’s still difficult to pull data crucial to pandemic response from EHRs, KHN’s Fred Schulte writes.
—The Washington Post’s Drew Harwell writes about tools employers might use to track remote work.