Advocacy Dispatch | Vol. 2 | 5.6.19

State HIT Day

The NorCal & SoCal Advocacy Teams are headed to Sacramento Tuesday, May 7!  Representatives from both chapters will be discussing Telehealth and Interoperability and meeting with legislators on the following state bills:

Number: CA [R] AB 744
Sponsor: Asw. Cecilia Aguiar-Curry (D-CA)
Title: Healthcare coverage: telehealth.
Description: “This bill would delete .. interactive communication provisions [in existing law that require] a Medi-Cal patient receiving teleophthalmology, teledermatology, or teledentistry by store and forward to be notified of the right to receive interactive communication with a distant specialist physician, optometrist, or dentist, and authorizes a patient to request that interactive communication.” It would also “require a health care service plan / insurer to reimburse a health care provider for the diagnosis, consultation, or treatment of a telehealth patient on the same basis and to the same extent that the health care service plan or health insurer is responsible for reimbursement for the same service through in-person diagnosis, consultation, or treatment.”

Number: CA [R] AB 1494
Sponsor: Asw. Cecilia Aguiar-Curry (D-CA)
Title: Medi-Cal: telehealth: state of emergency
Description: “This bill would provide .. that neither face-to-face contact nor a patient’s physical presence on the premises of an enrolled community clinic is required for services provided by the clinic to a Medi-Cal beneficiary during or immediately following a state of emergency, as specified. .. The bill would require that telehealth services, telephonic services, and other specified services be reimbursable when provided by one of those entities during or immediately following a state of emergency, as specified.”

Number: CA [R] AB 1676
Sponsor: Maienschein
Title: Health care: mental health
Description: “This bill would require health care service plans and health insurers .. to establish a telehealth consultation program that provides providers who treat children and pregnant and postpartum persons with access to a psychiatrist .. to more quickly diagnose and treat children and pregnant and postpartum persons suffering from mental illness.” 

Stay tuned for an update in our next newsletter!



HC3 Publishes Cost Analysis of Healthcare Sector Data Breaches Whitepaper

Key Takeaway: The HHS Health Sector Cybersecurity Coordination Center (HC3) released a white paper on the cost analysis of Healthcare Sector data breaches.

Why It Matters: With breaches on the rise due to the high value of healthcare data, the white paper released earlier this month looks into the costs inflicted by breaches on healthcare organizations.


NIST Publishes SP 800-163 Revision 1

Key Takeaway: The National Institute of Standards and Technology (NIST) published Special Publication (SP) 800-163 Revision 1, Vetting the Security of Mobile Applications.

Why It Matters: This revision expands on the original document by exploring resources that can be used to inform an organization’s requirements for mobile app security. It also details and refines the vetting model described in the original document by better defining the roles and processes that affect the mobile app vetting process.

Additionally, SP 800-163 Rev. 1 details how the mobile app vetting process might be integrated into an organization’s general security posture and explores the current threat landscape facing mobile apps.



CMS Finalizes Policies to Bring Innovative Telehealth Benefit to Medicare Advantage

Key Takeaway: The Centers for Medicare & Medicaid Services (CMS) finalized policies that will increase plan choices and benefits, including allowing Medicare Advantage plans to include additional telehealth benefits.

Why It Matters: These policies continue the agency’s efforts to modernize the Medicare Advantage and Part D programs, unleash innovation and drive competition to improve quality among private Medicare health and drug plans.

CMS is finalizing changes that would allow Medicare Advantage beneficiaries to access additional telehealth benefits, starting in plan year 2020. These additional telehealth benefits offer patients the option to receive healthcare services from places like their homes, rather than requiring them to go to a healthcare facility. Before this year, seniors in Original Medicare could only receive certain telehealth services if they live in rural areas. Starting this year, Original Medicare began paying for virtual check-ins across the country, meaning patients can connect with their doctors by phone or video chat. Historically, Medicare Advantage plans have been able to offer more telehealth services, compared to Original Medicare, as part of their supplemental benefits. But with the final rule, it will be more likely that plans will offer the additional telehealth benefits outside of supplemental benefits, expanding patients’ access to telehealth services from more providers and in more parts of the country than before, whether they live in rural or urban areas.



Sen. Markey Introduces Comprehensive Privacy Legislation

Key Takeaway: Sen. Ed Markey (D-MA) has introduced the Privacy Bill of Rights Act (S.1214), comprehensive privacy legislation.

Why It Matters: The California Consumer Privacy Act (CCPA), repeated privacy violations by social media moguls and Government Accounting Office (GAO) reporting a need for consumer data privacy legislation have brought the issue of consumer data privacy to the forefront.

Within that conversation is protected and sensitive information, which many agree includes healthcare patient data. This bill is one of the first comprehensive consumer data privacy proposals, and Markey offers an “opt-in” approach to handle sensitive data. What this potentially means is, for all apps with access to sensitive healthcare data, the data cannot be touched by the company, used in secondary means, or aggregated for third party data brokers without the consumer’s express consent. We expect the House to introduce a similar bill in the coming months.



CMS Publishes FY20 IPPS – Changes Made to PI Program

Key Takeaway: On April 23, CMS published the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2020 Rates.

Why It Matters: In the rule, CMS proposes changes to the Medicare and Medicaid Promoting Interoperability Programs. Namely, they are proposing an EHR reporting period of a minimum of any continuous 90-day period in CY 2021 for new and returning participants (eligible hospitals and critical access hospitals).

Also, they are proposing to continue for CY 2020 the Query of PDMP measure as optional and available for bonus points. CHIME and others had called for this approach, citing unforeseen challenges from implementation difficulties and provider burden in a requirement finalized last year. To minimize burden, we also propose converting this measure from a numerator/denominator response to a yes/no attestation, beginning with the EHR reporting period in CY 2019.

The CMS fact sheet is available here.


CMS Releases Skilled Nursing Payment Rule

Key Takeaway: CMS released its annual payment rule for skilled nursing facilities (SNFs), which updates payment rates and makes policy changes for the coming fiscal year.

Why It Matters: The proposed rule would establish two new performance measures for SNFs that measure sharing of health information from the SNF to other providers and to the patient. This aligns with CMS’s MyHealthEData initiative and ongoing efforts to increase care coordination and health data interoperability.

The fact sheet can be found here.


HHS To Deliver Value-Based Transformation in Primary Care

Key Takeaway: U.S. Department of Health and Human Services (HHS) Secretary Alex Azar and CMS Administrator Seema Verma announce the CMS Primary Cares Initiative, a new set of payment models designed to transform primary care to deliver better value for patients throughout the healthcare system.

Why It Matters: The new models use 2015 Edition Certified Electronic Health Record Technology (CEHRT), support data exchange with other providers and health systems via APIs and connect to their regional health information exchange (HIE).

For a fact sheet on the CMS Primary Care First payment model options, please go here. More information on CMS Primary Care payment model options is here.


Senate HELP Committee to Hold Second 21st Century Cures Hearing

Key Takeaway: On May 7, the Senate Health, Education, Labor, and Pensions (HELP) Committee will hold its second hearing on the implementation of the 21st Century Cures Act titled, “Implementing the 21st Century Cures Act: Making Electronic Health Information Available to Patients and Providers, Part II.”

Why It Matters: The first hearing had a panel of industry leaders discussing the possible effects, industry worries and implementation of the interoperability rules stemming from the 21st Century Cures Act. The two witnesses testifying in the second hearing will be Don Rucker, MD, ONC’s National Coordinator for Health Information Technology, and Kate Goodrich, MD, director and CMS chief medical officer at the Center for Clinical Standards and Quality.


July 2019 Hospital Compare Preview Data Available

Key Takeaway: As part of the Hospital Inpatient Quality Reporting (IQR), Hospital Outpatient Quality Reporting (OQR) and Prospective Payment System (PPS)-Exempt Cancer Hospitals Quality Reporting (PCHQR) programs, hospitals have 30 days to preview their data prior to public reporting on Hospital Compare.

Why It Matters: The July 2019 Hospital Compare preview data will be available from April 22-May 21 on QualityNet.

The preview period is for hospitals and facilities participating in the following programs:

  • Hospital IQR Program
  • Hospital OQR Program
  • PCHQR Program

Hospitals can find these help guides on QualityNet:

Hospitals can also find these quick reference guides to help with content preview:



SAMHSA Rural Opioid Technical Assistance Grants

Key Takeaway: The Substance Abuse and Mental Health Services Administration (SAMHSA) is accepting applications for fiscal year (FY) 2019 Rural Opioid Technical Assistance Grants.

Why It Matters: The purpose of this program is to develop and disseminate training and technical assistance for rural communities on addressing opioid issues affecting these communities. It is expected that grantees will facilitate the identification of model programs, develop and update materials related to the prevention, treatment and recovery activities for opioid use disorder (OUD), and ensure that high-quality training is provided. The U.S. Department of Agriculture has recently identified opioid misuse in rural America to be one of the areas of focus of these programs. Apply for the grants here.