• HHS Releases E-Health and Telemedicine Report to Congress
  • November 16, 2016 | Authors: Alexis S. Gilroy; Kevin D. Lyles; Robert A. (Bob) Naeve; Cristiana Spontoni; Soleil E. Teubner
  • Law Firms: Jones Day - Washington Office ; Jones Day - Columbus Office ; Jones Day - Irvine Office ; Jones Day - Brussels Office ; Jones Day - San Francisco Office
  • On August 12, 2016, the U.S. Department of Health and Human Services ("HHS") released its Report to Congress: E-health and Telemedicine ("Report") in response to a Congressional request for HHS to provide an update on its telehealth efforts. The Report offers background on telehealth modalities, discusses current telehealth policy challenges, and highlights federal telehealth activity. As background, the Report cites the importance of telehealth services (defined broadly to include live video interactions, store-and-forward technologies, remote patient monitoring, and mobile health apps) as a means to increase access to care, improve health outcomes, and reduce health care costs.

    The Report then highlights a number of challenges to widespread use of telehealth, including reimbursement/payment issues, state licensure barriers, and gaps in access to affordable high-speed broadband connections in rural hospitals and clinics. According to the Report, four out of five states require out-of-state clinicians providing telehealth services to be licensed in the state where the patient resides, highlighting the importance of licensure flexibility for physicians utilizing telehealth modalities. In addition, the Report notes that the payment environment for telehealth services continues to evolve. Medicare fee-for-service spending on telehealth services amounted to less than 0.01 percent of total spending by Medicare on health care services in 2015, while reimbursement for telehealth by Medicaid and private insurers varies greatly (48 state Medicaid programs currently provide some level of telehealth coverage, and 22 percent of large employers in 2014 covered telemedicine consultations, with more than 68 percent set to do so by 2017).

    Despite challenges, HHS continues to invest in telehealth, particularly through Medicare, Medicaid, and the Indian Health Service. In addition, other HHS Operating Divisions, such as the Health Resources and Service Administration ("HRSA"), the Agency for Healthcare Research and Quality, and the Office of the National Coordinator for Health Information Technology ("ONC") support telehealth activities, the development of mobile technologies, and other research programs. Importantly, the Report concludes by noting that HHS's legislative proposal for 2017 would expand the ability of Medicare Advantage organizations to deliver certain medical services via telehealth by eliminating otherwise applicable Part B requirements that certain covered services be provided exclusively through in-person encounters.

    GAO Issues Report on Electronic Health Information

    In August 2016, the U.S. Government Accountability Office ("GAO") released a report to the Senate Committee on Health, Education, Labor, and Pensions entitled "Electronic Health Information, HHS Needs to Strengthen Security and Privacy Guidance and Oversight" ("Report"). The Report found that while electronic health information can offer substantial benefits to providers and patients, the systems for storing and transmitting such information are vulnerable to cyber-based threats. The number of data breaches involving health care records has increased dramatically in recent years, from zero breaches in 2009 to 56 breaches in 2015 (involving more than 113 million records). According to the GAO, although HHS has published HIPAA compliance guidance for covered entities, such as health plans and health care providers, that guidance does not address all elements called for by other federal cybersecurity guidance. According to the Report, in order to improve effectiveness of HHS guidance and oversight of privacy and security for health information, HHS should update its guidance for protecting electronic health information to address key security elements, improve the technical assistance it provides to covered entities, follow up on corrective actions, and establish metrics for gauging the effectiveness of its audit program.