At the heart of our healthcare system lies two core, yet competing, philosophies: (1) clinical decisions must not be driven by profit, and (2) dollars drive behavior and, by harnessing this revenue, clinical outcomes can be vastly improved while the costs to the system of unnecessary care can be dramatically reduced. Here at HLTH, venture capital firm General Catalyst announced it is seeking to change that paradigm with the launch of its Health Assurance Transformation Corporation (HATCo), seeking to transform healthcare with global risk arrangements while leveraging data and technology. Continue Reading At HLTH 2023: General Catalyst’s HATCo Introduces a Radically Ambitious and Transformative Model for Healthcare
Recently, we were invited to speak on a panel at the Executive War College on Diagnostics, Clinical Laboratory and Pathology Management. We spoke about the federal information blocking rules, and highlighted how some actors are still engaging in conduct that the rules were intended to discourage, in part due to the lack of enforcement rules.Continue Reading Laboratory and Pathology Information Blocking Concerns
Utah Bill Uses Telehealth to Address Mental Health
On March 2, 2021, Utah Governor, Spencer Cox, signed Senate Bill 41 (“SB41”) into law. The bill, sponsored by State Senator Luz Escamilla, allows coverage for mental health services delivered by telehealth – often referred to as “telemental health” services. While we have seen many states move to create greater access to telehealth services in efforts to address the current public health crisis (the “Pandemic”), Utah is one of the first states to expand telehealth coverage to address the mental well-being of its citizens. In a statement to State of Reform, Sen. Escamilla noted that “mental health is becoming a big crisis and in our state we’re seeing an increase in needs, and access has become very limited.”
Continue Reading The “State” of Telehealth: Utah
West Virginia Bill Seeks to Regulate Parity and Out-of-State Providers
On February 10, 2021, members of the West Virginia Legislature introduced Senate Bill 1 (“SB1”) which seeks to regulate the use of telemedicine in the state. If passed, the proposed bill would require the Public Employees Insurance Agency, Medicaid and specified insurance plans to cover telehealth services at the same rate as in-person healthcare, starting July 1, 2021. The bill would also permit healthcare providers who are licensed in other states to provide telehealth services in West Virginia.
Continue Reading The “State” of Telehealth: West Virginia
Washington State Seeks to Make Audio-Only Telehealth Permanent
On February 5, 2021, Washington State Rep. Marcus Riccelli introduced House Bill 1196 (“HB-1196”) which seeks to set specific guidelines for use and coverage of audio-only telehealth platforms, such as the phone. HB-1196 would mandate coverage for audio-only telehealth beyond the public health emergency (the “Pandemic”) as long as the service met certain requirements. The bill was passed almost unanimously by the House on February 24, 2021 and is now before the state Senate.
Continue Reading The “State” of Telehealth: Washington
Oregon Telehealth Bill Proposes Parity for Telehealth Services
On January 11, 2021, Oregon Senator Lee Beyer and Rep. Rachel Prusak, introduced Senate Bill 11 (“SB11”), which would permanently extend parity for telehealth services with in-clinic care services. Parity for telehealth services was originally proposed in response to Governor Kate Brown’s March 23, 2020 Executive Order 20-22 which ordered a temporary halt on nonurgent procedures to preserve personal protective gear for frontline workers. Telehealth services provided clinical providers with an opportunity to maintain revenue by allowing individuals to seek care from the safety of their own homes. In line with the move to telehealth services, emergency payment policies enacted by the Oregon Department of Consumer and Business Services and payers’ voluntary agreement allowed providers to receive the same rates for telemedicine services as they would for in-clinic services.
Continue Reading The “State” of Telehealth: Oregon
Texas Governor Wants to Make Permanent Changes to Telemedicine Access
As part of his 2021 of the State address, Texas Governor, Greg Abbott, introduced his intention to permanently expand telemedicine services that were made available during the COVID-19 public health emergency (the “Pandemic”).
Continue Reading The “State” of Telehealth: Texas
New Hampshire Seeks to End Telehealth Parity and Audio-Only Phone Coverage
On January 13, 2021, New Hampshire lawmakers, Jess Edwards, Jason Osborne and John Hunt, introduced House Bill 602, which seeks to roll back certain provisions of the July 21, 2020 telehealth bill (“House Bill 1623”) signed into law by Governor Chris Sununu, during the height of the COVID-19 public health emergency (the “Pandemic”). House Bill 1623, amended the state’s definition of telemedicine to include new modalities, including audio-only phones, and requires Medicaid and private payers to reimburse for telehealth services on the same basis that it reimburses for in-person care. In sharp contrast, the newly proposed House Bill 602 would revise the state’s telehealth rules to eliminate payment parity and coverage for audio-only services.
Continue Reading “State” of Telehealth Series: New Hampshire
New York Telehealth Reforms – 2021 and Beyond
The Empire State continues its expansion of telehealth adoption as Governor Andrew Cuomo introduced a number of proposals as part of his 2021 State of the State agenda set to “permanently adopt COVID-19-era innovations” in telehealth. The proposals are part of a wave of proposed legislation meant to cement the changes in telehealth regulation necessitated by the COVID-19 pandemic (the “Pandemic”). Building on New York State’s adoption of Senate Bill S8416 over the summer which had already made a permanent change in the expanded definition of telehealth to include audio-only telephone communication, if adopted the proposal would provide licensing reciprocity in certain specialties, as well as remove traditional prerequisites to the provision of telehealth.
Continue Reading “State” of Telehealth Series: New York
Permanency for Out of State Telehealth Services? Arizona Seeks to Make Permanent Changes to Licensure Requirements
On January 11, 2021, Arizona Governor Doug Ducey delivered the “State of the State” address in which he outlined his vision for 2021, focusing on the State’s response to the COVID-19 pandemic (the “Pandemic”), the distribution of the vaccine, and other COVID-19 related and unrelated priorities. Governor Ducey’s priorities are summarized in the Governor’s 2021 Arizona Resilient Policy Book (“2021 Policy Book”).
Continue Reading “State” of Telehealth Series: Arizona
G force is used to describe the acceleration of an object relative to gravity. The Wright brothers understood that the lift of the airplane had to be greater than the force of gravity. In much the same way, the pull of gravity that healthcare providers are facing today is COVID-19.
Continue Reading And We Have Lift-Off: Improvements in Healthcare Revenue Cycle Management to Address COVID-19 Challenges