Telemedicine for All, As Lame Duck Session Winds Down

Even with the federal legislators poised to head home at the end of the week, two significant telehealth measures continue to work their way through the House and Senate, further evidence that telehealth services have become an increasingly important facet of an ever-evolving U.S. health care system.

In the week since we issued the “Interconnected: Digital Health Spans Key Issues From Counterfeit Medicines to Opioid Epidemic” update, three pieces of legislation touching on telehealth have passed one Chamber, with votes expected in the other Chamber this week:

• 21^st Centure Cures Act (Amendment to H.R.34)
  
  Passed House 392-26 on November 30, 2016. Passed Senate 85-13 to invoke cloture on December 5, 2016; vote forthcoming
  
  A sprawling $6.3 billion health care policy omnibus, 21st Century Cures addresses telehealth in two sections:
  • Section 4013 requires the Centers for Medicare and Medicaid Services, the Center for Medicare and Medicaid Innovation, and the Medicare Payment Advisory Committee (MedPAC) to develop a report outlining solutions for expanding telehealth services to Medicare beneficiaries showing the technology and delivery systems safety, effectiveness and quality as well as any barriers to prevent expansion; and
  • Section 10002 expands pediatric access to mental health care to include the development of regional or statewide pediatric mental health care telehealth access programs through Health Resources and Services Administration grants to states, political subdivisions of states and Indian tribes, and tribal organizations.


• National Defense Authorization Act for FY2017 (H.R.4909 / S.2943)
  
  Conference report passed 375-34 on December 2, 2016. Final bill expected to pass it this week.
  
  The National Defense Authorization Act of Fiscal Year 2017 provides for the expansion of telehealth coverage to TRICARE beneficiaries. The Act requires the Secretary of Defense to incorporate telehealth services — including secure physician-patient messaging, video and telephone apps, and remote patient monitoring — within 18 months of enactment. Further, coverage for these services must be made to the same extent as those available to beneficiaries for in-person services via the reduction or elimination of copays or cost-sharing.


• The Expanding Capacity for Health Outcomes (ECHO) Act (S.2873 / H.R.5395)
  
  Passed Senate 97-0 on November 29, 2016. Passed House by voice vote without objection on December 6, 2016. Bill headed to President Obama's desk for signature.
  
  The ECHO Act sponsored by Senators Orrin Hatch (R-UT) and Brian Schatz (D-HI) requires the Department of Health and Human Services to study the benefits of distance education and technology-enabled learning for health care providers to improve patient care. The House companion bill sponsored by Representatives Michael Burgess (R-TX) and Doris Matsui (D-CA), may be voted on later this week.

As passed, each of these three pieces of legislation would mark a step forward in increasing access and coverage of telehealth services. FaegreBD Consulting will continue to monitor this and future digital health legislation as it moves through Congress.