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Expand USF for Telehealth?

COVID-19 Telehealth Audit Procedures 'Being Discussed:' FCC Staffer

The FCC is “aware obviously of the need for telehealth” and “on the lookout” for what it can do to “more effectively assist with the development of telehealth” beyond the pandemic, said Nathan Eagan, acting deputy chief-Wireline Bureau Telecom Access Policy Division, during an FCBA webinar Monday. The agency’s order for round 2 of the COVID-19 telehealth program reflected the “input and discussions” from all commissioners on the “specific parameters,” Eagan said, noting audit procedures for round 2 are “still being discussed.”

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COVID-19 telehealth program recipients are required to submit post-program reports to the FCC and will “help the commission better understand what its role might be with telehealth in the future,” Eagan said. It’s “unclear at the moment” whether there will be future rounds of funding for this program because it relies on congressional appropriations, he said, saying the FCC is working to ensure it can “efficiently prepare” to facilitate telehealth in “whatever way that we can.”

Funding the COVID-19 telehealth program through the USF “sounds like a great idea to me,” said Shira Hollander, American Hospital Association senior associate director-policy development. “I worry that some of the momentum is getting lost” on telehealth, Hollander said. There’s an effort underway to extend Centers for Medicare & Medicaid Services’ waivers for two years, and Congress “probably won’t do anything else for two years” if it chooses to do that, she said. But “there would be a lot of changes required for that to happen,” Eagan said, noting the connected care program is currently funded by USF.

Allowing rural and nonrural providers to apply for the COVID-19 telehealth program was “significant” for AHA members, increasing access to care, continuity of care, and providing extra capacity, Hollander said. Access to telehealth services “fundamentally rests on the ability to get a connected device into a patient’s hand.”

Some AHA members said they struggled during the first round of the telehealth program with getting a response to their application and selections, Hollander said, and others said they were waiting “many months to actually see the funding” they were awarded. “The application process was challenging,” she said, noting these concerns from members were less reported during round 2.

Demand for the COVID-19 telehealth program also “far exceeded the available funding,” she said, saying AHA backs additional funding and expanding eligibility to “all direct health facilities.” The FCC made changes to the application process for round 2, thinking this “would be more equitable” for interested providers, Eagan said.

Hollander welcomed some CMS' changes during the pandemic. The “most significant” was waiving certain rules to allow Medicare to pay for telehealth services in the home, Hollander said. It was “very successful” and “underscores the importance of access to broadband, end-to-end user devices, and … the knowledge of how to use those,” she said, noting another major change was CMS allowing a wider range of providers to offer telehealth. Also Monday, a coalition of 335 organizations sent a letter to congressional leadership asking to expand CMS telehealth waivers through the end of 2024.