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Washington Debrief: Telehealth Subject of Senate Hearing, Legislation

April 27, 2015
by Leslie Krigstein, Interim Vice President of Public Policy
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Leslie Krigstein, Interim Vice President of Public Policy

Congressional Affairs:

Telehealth Subject of Senate Hearing, Legislation

Key Takeaway: Telehealth services and rules governing the reimbursement of such services under Medicare were a hot topic on Capitol Hill last week.

Why It Matters: Legislators are seeking opportunities to instruct Medicare to reimburse for the delivery of telemedicine services in the same way that the agency reimburses in-person care episodes.

The Senate Committee on Commerce, Science and Transportation's Subcommittee on Communications, Technology, Innovation and the Internet held a hearing last Tuesday to examine how the use of telehealth has helped lower costs and improve patient outcomes. Issues discussed during the hearing entitled “Advancing Telehealth through Connectivity” included: the shortage of promotion for telehealth by the Federal Communications Commission, the lack of interstate licensing, poor broadband connectivity, and provider reimbursement limitations. The subcommittee members largely agreed with increasing the use of telehealth, with many of the lawmakers calling on Medicare to reimburse for such services.

Senator Edward Markey (D-MA) raised concerns about the privacy of patients' health records. He suggested that Congress may need to pass legislation that would create security practice requirements for telehealth providers.

Further, Subcommittee Chairman Roger Wicker (R-MS) announced plans to reintroduce, with Senator Thad Cochran (R-MS), a bill that would extend Medicare coverage for telehealth services provided in underserved areas. The so-called “Telehealth Advancement Act,” would seek to bring parity in payment and help improve Medicare reimbursements. Specifically, the bill would authorize accountable care organizations (ACOs) covered by Medicare Advantage plans to be reimbursed for providing telehealth and remote patient monitoring services and expand the number of hospitals nationwide eligible to receive Medicare reimbursement for telehealth services. The bill was introduced during the 113th Congress, but was never voted on.

Information Sharing Bills Pass House with Bipartisan Support

Key Takeaway: With impressive bipartisan support, two legislative proposal to encourage cyber threat information sharing were passed by the House of Representatives last week.

Why It Matters: The ability to easily, safely and confidently share cyber threat indicators with government and private sector entities was a cornerstone of cyber security proposals from both the Obama administration and Congressional leaders. This week, the House easily passed legislation offering liability protections for organizations that share cyber threat information with government entities and other recognized organizations, such as the Information Sharing and Analysis Centers (ISACs), for the good of the American public.

Though there are many similarities between the bills, the proposals diverge over where the portal for information sharing would be located. Both bills would mandate the removal of personal information by entities before it's shared, with HR 1560 requiring an additional scrub by the government. Both pieces of legislation will sunset after seven years.

The Protecting Cyber Networks Act (HR 1560) was passed by the House last week but a vote of 307-116, after being approved by the Intelligence Committee on March 26. The legislation would enable the president would to decide which agency is responsible, so long as it isn't with the Defense Department or National Security Agency. This bill would grant liability protections when companies are giving data to any civilian agency, such as the Treasury or Commerce Departments.

The National Cybersecurity Protection Advancement Act of 2015 (HR 1731) passed the House by a vote of 355-63 last Thursday. This legislation which came out of the House Committee on Homeland Security under the leadership of Chairman Michael McCaul (R-TX-10) on April 14. The bill designates the Department of Homeland Security (DHS) to host the portal. This legislation only gives companies liability protections when sharing data with the DHS, this proposal is viewed to be stronger on privacy. Now that both proposal have been passed by the House, the leadership has indicated that HR 1731 will become a provision of HR 1560.

In a similar fashion, the Senate plans to consider the Cybersecurity Information Sharing Act (CISA) of 2015 (S. 754), perhaps as early as the first week of May. In March, the Select Committee on Intelligence reported CISA out of the Committee for consideration by the full Senate, by a strong bipartisan vote of 14 to 1. The legislation is designed to encourage the sharing of data between private companies and the government to prevent and respond to cybersecurity threats.

All three legislative proposal are sector agnostic, without any special consideration or deference to the healthcare sector. However, the Senate Committee on Health, Education, Labor and Pensions continues to evaluate cyber security challenges in healthcare settings.