Among the more than 5,500 pages of the coronavirus relief bill passed by Congress this week were a number of provisions aimed at expanding broadband and telehealth services, as well as addressing the needs of rural hospitals.

The wide-ranging bill was still embroiled in controversy by Wednesday, with President Donald Trump pushing for more stimulus money for individuals and some members of Congress, such as Rep. Alexandria Ocasio-Cortez (D-N.Y.) saying they hadn't had time to read the mammoth legislation.

Digital health advocates also expressed mixed feelings, with the American Telemedicine Association representatives saying the organization appreciated some of the provisions in the bill while noting other ways in which it fell short. 

"The noticeable lack of permanent reform or a guaranteed extension of the telehealth flexibilities in this relief package is disheartening for the millions of Americans who relied on telehealth to access care, and our healthcare providers still on the frontlines of the pandemic," said ATA CEO Ann Mond Johnson in a statement.

WHY IT MATTERS

The bill included billions of dollars in broadband expansion investments, with $3.2 billion aimed at allowing low-income families to pay their monthly Internet bills.

Lawmakers also allocated $1.3 billion toward strengthening Internet infrastructure in rural and tribal areas and $65 million to map which parts of the country still need broadband access, according to an analysis from The Washington Post.

In addition, they included a jump in funding for the Federal Communications Commissions' telehealth work, which health systems have used to ramp up their telemedicine offerings over the last year.

"The ATA credits Congress with increasing funding for the FCC’s telehealth work and allowing for the expansion of broadband, two important steps forward. We are also grateful that Congress included Medicare coverage for telemental health services, just one of the many clinical specialties that benefitted from telehealth during the COVID-19 public health emergency," said Johnson.

"However, we are disappointed that the telemental health provision includes an in-person requirement, as we strongly believe a provider-patient relationship can be established via telehealth. Particularly in light of the crippling provider shortage, this in-person pre-existing relationship requirement will unnecessarily deprive Medicare beneficiaries of telemental health options, and we are hopeful Congress will remove this provision in the near future," Johnson continued.

The bill also would give the Office of the National Coordinator for Health IT $62 million for necessary expenses, "including grants, contracts, and cooperative agreements for the development and advancement of interoperable health information technology."

And it would appropriate $2 million for a pilot program assisting rural hospitals in improving long-term operations via technical assistance, and $25 million for the Technology Modernization Fund.

The provisions also included a move to end surprise medical billing through arbitration, which has sparked both support and resistance.

"We are pleased Congress has taken a first step toward protecting people from unfair and costly surprise medical bills, and that patients will now be taken out of the middle in these situations – including those involving air ambulances. We remain concerned that a complex arbitration process, which has been ineffective in states that have tried it, holds the potential to raise premiums for everyone," said Blue Cross Blue Shield Association SVP of the office of policy and representation Justine Handelman.

THE LARGER TREND

As Johnson noted, the bill failed to address the need for long-term telehealth reform, which Congress has repeatedly floated in multiple stalled bills. Although the U.S. Centers for Medicare and Medicaid Services made some telehealth coverage permanent earlier this month, Administrator Seema Verma said legislative action would be necessary to achieve more results.

ON THE RECORD

"There is still much work to be done to set the course ahead for access to telehealth following the public health emergency," said Johnson.

"The ATA remains optimistic that we will see movement in the new Congress during the months ahead and will continue to work to ensure access to telehealth becomes a permanent modality in a hybrid delivery system that includes both in-person and virtual care," she added.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.