By David Pittman | 12/06/2017 10:00 AM EDT
With help from Arthur Allen (@athurallen202)
LAWMAKERS WORKING ON 'EXTENDERS,' TELEMEDICINE BILL: Republicans and Democrats on the House Ways and Means Committee are figuring out how to make it easier for Medicare Advantage plans to cover telemedicine as part of a bill that would also delay certain Obamacare taxes, Pro's Jennifer Haberkorn reports. Lawmakers are considering two-year suspensions of the taxes and changes to requirements for health savings accounts. House Ways and Means Chairman Kevin Brady told reporters Tuesday that negotiations involve the medical device tax, health insurance tax and the Cadillac tax.
-The provisions would be bundled into a larger package that renews a series of policies known as "Medicare extenders." The legislation (H.R. 3727 (115) ) would let private Medicare plans account for telemedicine in annual bids to CMS, making it financially more attractive to offer services as a standard benefit. Health plans currently must either cover the cost of telemedicine visits with government rebates or require beneficiaries to pay higher premiums. Since the CBO projected the measure would save Medicare $80 million over a decade, lawmakers are using it as an offset for other Medicare extender programs.
-Lawmakers are working to pass a number of significant pieces of legislation before the end of this year, including at least two bills to fund the government, tax reform, children's health insurance and a number of other issues. "Chairman Kevin Brady and ranking member Richard Neal released a bipartisan, paid for agreement on extenders. Members are continuing to work with the Senate to find common ground and take action on extenders this year," a Ways and Means spokesperson tells Morning eHealth.
DRIVING THE DAY: HHS HOSTS OPIOID, TECH SYMPOSIUM: HHS's Chief Technology Office will host a day of "TED Talk style" remarks today to promote ways to leverage technology and data to help address the nation's opioid epidemic. Speakers include acting HHS Secretary Eric Hargan, Surgeon General Jerome Adams, HHS Chief Technology Officer Bruce Greenstein, John Walters, former director of the White House Office of National Drug Control Policy, and others.
HHS is also hosting a corresponding Code-a-Thon to develop data-driven solutions to the opioid epidemic. HHS will award three prizes, up to $10,000 each, to teams of coders who develop solutions to key problems in treatment, prevention and understanding opioid usage.
eHealth tweet of the day: Brian Eastwood @Brian_Eastwood: Spend 10 minutes at dentist I've seen for 5 years filling out forms, all b/c office recently changed ownership. Your daily reminder that the tech that will fix healthcare is far from sexy.
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WILL ONC'S TRUSTED FRAMEWORK BE TOO ALL-ENCOMPASSING? HHS's health IT office must find what works for various health IT groups - like CommonWell, the Sequoia Project, DirectTrust, NATE and so on - and create a health exchange framework that moves the needle, said Maya Uppaluru, an associate at the Washington law firm Crowell & Moring and former ONC policy advisor. ONC's draft trusted exchange framework will need to balance expediting health data exchange against the risk of "a watered down product", she said. "It's a big challenge," Uppaluru said. "We'll see what they do with it."
An ONC spokesperson, when reached for comment, said the office looks forward to hearing from stakeholders once the framework is released, which is expected later this month.
Background: The 21st Century Cures Act (H.R. 34 (114)) required ONC create a trusted exchange framework, a set of terms and conditions on health information exchange to make agreements between disparate groups easier.
ONC ON FHIR: ONC is creating a new Payer-Provider FHIR Taskforce, the office said Tuesday. Its aim is to find ways to speed the adoption of HL7 FHIR between payers and providers.
TELEMEDICINE MAY BE LUXURY WITHOUT MEDICARE DOLLARS: Congress has struggled for years to change federal law to get Medicare to pay for more telemedicine. But if lawmakers can't do it soon, hospitals may not be able to recoup money they've invested in the technology and stop offering telemedicine altogether, said Terry Lewis, associate counsel for the University of Pittsburgh Medical Center who focuses on telemedicine implementation.
"I know how tight the margins are. I live and breathe in the health care world every day. You're going to see health systems that are going to start maybe cutting back on technology, maybe not doing so much telemedicine," Lewis said at the ABA's Washington Health Law Summit Tuesday. "I know we're not going to stop. It's part of our mission, our community and everything else. But I wouldn't be surprised to see that."
MEDPAC SUGGESTS TELEMEDICINE IN NEW REPORT: Telemedicine should be considered by CMS when determining the right level of oversight for rural hospitals' outpatient therapy, congressional advisers on Medicare say. CMS has said that doctors must be immediately available to help critical access hospitals' outpatient therapy services. The "direct supervision" requirement would hurt hospitals, they say. Congress stopped CMS from enforcing the ban from 2013 to 2016, and CMS is considering not enforcing the move for 2018 and 2019.
- But the Medicare Payment Advisory Commission says in a new report that CMS should think about using telemedicine for delivering therapeutic services when appropriate. The MedPAC report.
OBJECTIONS RAISED OVER TELEHEALTH DEFINITON: A trade group representing some of the country's largest employers is asking North Dakota to reconsider its recently proposed telemedicine regulations. ERIC, the ERISA Industry Committee, takes issue with a requirement that doctors see patients through video. A 2015 state law defined telemedicine as "the use of interactive audio, video, or other communications technology that is used by a health care provider or health care facility at a distant site to deliver health services at an originating site...." A video requirement might be a barrier to patients in rural parts of the state who lack a fast, reliable internet connection. Read the full letter from ERIC to the North Dakota Board of Medicine.
-"There's no data to show video is best," said Donna Campbell, a member of the Texas State Senate and an emergency care physician who works with Teladoc, told the Bismark Tribune. She said 95 percent of Tealdoc's visits are done via "interactive audio."
ONC PROJECT COULD HAVE HELPED PUERTO RICO, IF IT WERE AROUND: ONC touted one if its prized achievements Tuesday at a Sequoia Project conference outside Washington, D.C. The ONC-funded project of the California Emergency Medical Services Authority goes under the surprisingly appropriate acronym PULSE, for Patient Unified Lookup System for Emergencies. It plugs providers who are working at emergency field hospitals into health information exchanges, enabling them to get information on evacuated patients who may not have their medications or records. The cloud-based software is currently linked to five health information exchanges in California.
"This is what would have been needed [during Hurricane Katrina] at the Superdome," said ONC official Lee Stevens, who works with health information exchanges. "This is what the Puerto Rican evacuees needed." Unfortunately, nothing like this was ready in the Caribbean after Hurricane Maria. At an ONC annual meeting session last week, Stevens says, people jumped up and said, "'I carried paper records out of Puerto Rico. I carried paper records out of the Virgin Islands. Why is this problem not solved?' There was a lot of anger."
"When we rebuild Puerto Rico we need to create this kind of infrastructure," said Luis Belen, CEO of the National Health IT Collaborative for the Underserved. Belen, a New Yorker of Puerto Rican descent, lost two great aunts during the storm.
The PULSE system was turned on during the fires in Northern California this fall, but it wasn't really used, said Dan Smiley of the California EMS Authority. There were connectivity problems and no real centralized field hospital for patients escaping the fires, he said. Still, officials in other states have expressed interest in implementing the software, which California is offering for free.
NIST RELEASES NEW CYBER FRAMEWORK DRAFT: NIST plans to update its widely adopted cybersecurity framework with more information about using it to secure supply chains, verify digital identities and disclose digital flaws, Pro's Eric Geller reports. The updated material appears in the newly published second draft of NIST's proposed update to the framework.
ELSEWHERE ON CAPITOL HILL: The Senate Commerce Committee will hold a hearing next week on artificial intelligence with IBM executive Dario Gil scheduled to testify.
Rep. Frank Pallone, top Democrat on the House Energy and Commerce Committee, requested a hearing on the proposed $69 billion merger between CVS and Aetna. Of course, it's the Republicans who have final say over what hearings are scheduled.
WHAT WE'RE CLICKING:
New Jersey considers opioid prescribing standards for EHRs, while Teladoc raises concern.
FDA honchos explain their work to make artificial pancreas a reality wasn't by acting obtuse toward technology.
The unintended consequences of artificial intelligence in radiology.
Is Blockchain ripe for health IT?
WIRED explains Crispr gene editing in an easy-to-understand way.
Lessons learned from the FDA's work on pacemaker cybersecurity.
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