Lujan Sees Support for Bipartisan Telehealth 'Initiative'

A Thursday Senate Communications Subcommittee hearing showed there is bipartisan support for a “strong telehealth initiative” that the Commerce and Health committees could together advance to the Senate floor this year, said subpanel Chairman Ben Ray Lujan, D-N.M., in an interview. Lawmakers noted interest in advancing the Temporary Reciprocity to Ensure Access to Treatment Act (HR-708/S-168) and Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act (HR-2903/S-1512), among other telehealth measures. Lujan and others also used the hearing as a venue to promote the need for further broadband money and air grievances about President Joe Biden’s delay in announcing nominees to the FCC and NTIA.

The FCC has been able to “make progress” on telehealth under acting Chairwoman Jessica Rosenworcel “even with” the commission’s 2-2 split, so “imagine the progress” the agency “could make” if it had five members, Lujan said at the end of the hearing. It’s “simply unacceptable and inexcusable there is no urgency” within the Biden administration to name a permanent FCC chair, a third Democratic commissioner or NTIA administrator. Lujan repeated his call for Biden to name Rosenworcel permanent chair. The issue also drew attention during a Wednesday House Communications Subcommittee hearing (see 2110060073).

HR-2903/S-1512 got bipartisan support, including from Senate Communications ranking member John Thune, R-S.D., and Sen. Brian Schatz, D-Hawaii. It would permanently remove geographic restrictions on access to telehealth services and make permanent several other temporary rules changes allowing expanded use of the technology during the COVID-19 pandemic. Some language from a previous version of the measure was included in the 2020 Coronavirus Aid Relief and Economic Security Act but applies only until the end of the epidemic (see 2003250046).

“Unless Congress acts” to enact HR-2903/S-1512, “we will go back to the Stone Age” on telehealth, with “very little access” to the technology, Schatz said. He suggested disruptions in healthcare delivery could be significant “if we don’t fix this.” Thune noted the measure has support from “more than half” of the Senate; as of Thursday 59 senators are signed on as co-sponsors, as are 106 House members. He also noted his refiled Reducing Unnecessary Senior Hospitalizations Act (HR-4890/S-2576), which would allow Medicare to contract with medical groups to use telehealth services at nursing home facilities.

Sen. Marsha Blackburn of Tennessee and other Republicans cited interest in advancing HR-708/S-168. It would allow temporary reciprocity of medical licenses across all 50 states for doctors “in good standing” during medical emergencies and public health emergencies like the current pandemic. “Reciprocity is really important” during such emergencies, said Sen. Roy Blunt of Missouri. FCC Commissioner Brendan Carr called the measure a “step in the right direction.” Geographic workforce restrictions are “an issue,” said telehealth provider Avel eCare CEO Deanna Larson. “It’s very important to us that geography is not limiting where we can see individual patients.”

Lujan focused during the hearing on the effect the $65 billion in broadband money included in the Senate-passed Infrastructure Investment and Jobs Act (HR-3684) would have on improving telehealth access across the U.S. “The solution must include access to affordable broadband internet service, support for connected devices, and access to digital literacy training,” he said. Communities that lack broadband access are “effectively cut off from” the benefits of telehealth. Senate Commerce Committee Chair Maria Cantwell of Washington, Sen. Amy Klobuchar of Minnesota and other Democrats also cited the need for improved broadband access to expand telehealth.

Larson and other witnesses called improving broadband access crucial to expanding telehealth. Improving broadband connectivity will support all types of telehealth, which “have the potential to expand access to best practice treatment and advance health equity in rural communities and urban underserved areas,” said University of New Mexico School of Medicine Project Echo Director Sanjeev Arora. Congress must also "ensure that patients in need can access end-user devices, such as tablets, to connect to digital health tools and invest in training and assistance so patients can confidently use those tools," said American Academy of Family Physicians President Sterling Ransone.

Thune, Senate Commerce ranking member Roger Wicker of Mississippi and other Republicans also noted the importance of broadband access to telehealth expansion but believe any further money should go to fully unserved communities. Wicker and Thune noted ongoing concerns with the FCC’s broadband coverage data collection work. It “always comes back to the maps,” Thune said. Wicker pressed Carr to communicate his desire for the FCC to treat the matter with “a sense of urgency.”

Wicker cited his Funding Affordable Internet with Reliable Contributions Act (S-2427), which would require the FCC to study “the feasibility of funding” USF “through contributions supplied by edge providers” (see 2107210067). The measure could “be a good way to ensure” the USF Rural Health Care Program and other programs are “on a sustainable path," he said. Carr restated his support for the bill.