December 20, 2016
Issue in Focus:
21st Century Cures Act Addresses Telehealth

21st Century Cures Act Addresses Telehealth
in Several Sections

HR 34, the 21st Century Cures Act was officially signed by President Obama earlier this month.  The 300 page document, which includes the Beau Biden Cancer Moonshot, incorporates telehealth in several of its sections (see below).  
  1. HR 34 establishes a Health Information Technology (HIT) Advisory Committee.  The committee’s target areas include HIT infrastructure, privacy and security, facilitation of secure access to protected health information, and other target areas to be identified by the committee.  HR 34 also identifies additional target areas that the HIT Advisory Committee may want to make recommendations on, including HIT’s ability to improve the quality of health care, use of technology to address needs of children and other vulnerable populations, use of electronic systems to ensure comprehensive demographic data collection, and use of self-service, telemedicine, home care and remote monitoring technology, among others.  See the legislation for the complete list.
  2. Requires the Administrator of the Centers for Medicare and Medicaid Services (CMS), not later than 1 year after enactment, to provide to Congress information on the following:
    • The population of Medicare beneficiaries whose care may be improved most in a manner that meets or exceeds the existing limitations of telehealth services under section 1834(m)(4);
    • Activities by the Center for Medicare and Medicaid Innovation (CMMI) which examine the use of telehealth services in models, projects or initiatives funded by CMMI;
    • Types of high volume services which might be suitable for using telehealth; and
    • Barriers that prevent expansion of telehealth under 1834(m)(4).
  3. Requires Medicare Payment Advisory Commission (MEDPAC) to provide to Congress, not later than March 15, 2018, information using quantitative and qualitative research methods on telehealth services for which payment can be made under Medicare fee-for-service parts A and B as well as services reimbursed by private insurers when delivered via telehealth.  It also asks MEDPAC to identify services reimbursed by private insurers, but not reimbursed through Medicare, that should be considered for Medicare’s fee-for-service program.  
  4. Declares that it is the “sense of congress” that the list of eligible originating sites should be expanded when care is delivered in a safe, effective, high quality manner, it meets or exceeds the conditions of coverage and payment for in-person services and is clinically appropriate.
  5. Requires the substance abuse and mental health services administration to collaborate with the Secretary of Defense and the Secretary of Veterans Affairs to improve the provision of mental and substance use disorder services, including through the provision of services using the telehealth capabilities.
  6. Requires the Director of the Center for Mental Health Services to conduct services-related assessments, including evaluations of telemental health, among others.
  7. Establishes a training demonstration grant program that would require its grantees to provide at least 1 training track that is a virtual training track that includes an in-person rotation at a teaching health center or in a community-based setting, followed by a virtual rotation in which the resident or fellow continues to support the care of patients at the teaching health center or in the community-based setting through the use of health information technology and, as appropriate, telehealth services.  See bill for other required training tracks.  Applicants that demonstrate experience in HIT and telehealth (among other components) would be given priority.
  8. Amends language concerning a grant that may be made by the Secretary to enhance services for students with mental and behavioral health problems, requiring funds to only be used for one or more of a specific list of activities outlined in HR 34, which includes (among others) providing mental and substance use disorders prevention and treatment services to students, including through the use of telehealth services.
  9. Establishes the pediatric mental health care access grants which are intended to promote behavioral health integration in pediatric primary care by supporting the development and improvement of statewide or regional pediatric mental health care telehealth access programs.
For more information, see the complete text of HR 34.

Recent CCHP Resources
To find out about telehealth related laws, regulations and Medicaid programs in your state! 
Center for Connected Health Policy Website
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The Center for Connected Health Policy (CCHP) is a public interest nonprofit organization that develops and advances telehealth policy solutions to promote improvements in health and health care systems. 
In its work as the federally designated National Telehealth Policy Resource Center, CCHP provides technical assistance to twelve regional telehealth resource centers nationwide. This project is made possible by Grant #G22RH30365 from the Office of the Advancement of Telehealth, Health Resources and Services Administration, Department of Health and Human Services. 

CCHP is a program of the Public Health Institute and was created in 2008 by the California Health Care Foundation, who remains as its lead funder.
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