The Technical Assistance and Services Center (TASC), a program of the National Rural Health Resource Center (The Center), has created a specialized collection of telehealth resources.

The Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services defines telehealth as the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health, and health administration.

Telehealth is especially critical in rural and other remote areas without the full range of health care services and providers. The types of telehealth services have expanded over the past 20 years to increase access to health care. The COVID-19 pandemic has rapidly accelerated both the use and acceptance among patients, providers, and payers.

This collection of resources is tailored to the use and coverage of telehealth by rural providers. Within the collection are current and timely resources from federal agencies and organizations with a rural focus. Content is reviewed and updated regularly as relevant resources are published, and telehealth regulations change.

The U.S. Department of Commerce’s National Telecommunications and Information Administration (NTIA) announced the availability of $288 million in grant funding for the deployment of broadband infrastructure. Grants will be awarded to partnerships between a state, or political subdivisions of a state, and providers of fixed broadband service.

NTIA’s Broadband Infrastructure Program was established by the Consolidated Appropriations Act, 2021. In the priority order defined by the Act, NTIA will accept applications for projects that are designed to:

1. Provide broadband service to the greatest number of households in an eligible service area;
2. Provide broadband service to rural areas;
3. Be most cost-effective in providing broadband service; or
4. Provide broadband service with a download speed of at least 100 Mbps and an upload speed of at least 20 Mbps.

NTIA will group applications based on the priority above that each application addresses, and will sequence its review of application groups in the statutory order listed above.

“As a former governor, I know that state and local leaders have the best understanding of the gaps in their broadband infrastructure. This program will allow states and localities to partner with providers to target this funding toward the areas where it is most needed and can do the most good,” said U.S. Secretary of Commerce Gina M. Raimondo. “While these grants will lay the foundation, we know that we need even bolder investments in broadband expansion to finish the job. President Biden’s American Jobs Plan will provide the resources to continue these broadband infrastructure buildouts until one hundred percent of Americans have access to high-speed, affordable, and reliable broadband.”

“NTIA has built durable partnerships with the states through our State Broadband Leaders Network, and with local governments and their broadband initiatives through our technical assistance offerings and other efforts,” said Acting NTIA Administrator Evelyn Remaley. “We are eager to put these relationships to work to ensure a successful program that expands broadband infrastructure in communities that need it most.”

More information about the program, including requirements for grant applications, can be found in the Notice of Funding Opportunity published today on grants.gov. NTIA is also holding a series of webinars to further inform the public about the program. The next Broadband Infrastructure webinars will be held on June 9 and 10.

Do you have a patient with a cognitive impairment? Medicare covers a separate visit for a cognitive assessment so you can more thoroughly evaluate cognitive function and help with care planning.

3 Things You Need to Know:

1. If your patient shows signs of cognitive impairment at an Annual Wellness Visit or other routine visit, you may perform a more detailed cognitive assessment and develop a care plan.
2. The Cognitive Assessment & Care Plan Services (CPT code 99483) typically start with a 50-minute face-to-face visit that includes a detailed history and patient exam, resulting in a written care plan.
3. Any clinician eligible to report Evaluation and Management (E/M) services can offer this service, including: physicians (MD and DO), nurse practitioners, clinical nurse specialists, and physician assistants.

Effective January 1, 2021, Medicare increased payment for these services to $282 (may be geographically adjusted) when provided in an office setting, added these services to the definition of primary care services in the Medicare Shared Savings Program, and permanently covers these services via telehealth.

Get details on Medicare coverage requirements and proper billing at cms.gov/cognitive.

On May 17, 2021, the Health Resources and Services Administration (HRSA) sent letters to six drug manufacturers stating that their policies placing restrictions on 340B Program pricing to covered entities that dispense medications through pharmacies under contract have resulted in overcharges and are in direct violation of the 340B statute.  In it’s letter HRSA is requiring each manufacturer to:

• Immediately begin offering its covered outpatient drugs at the 340B ceiling price to covered entities through their contract pharmacy arrangements and
• Refund or credit all covered entities for overcharges that resulted from the manufacturers’ policies regarding drugs dispensed by contract pharmacies.

The 340B Program Ceiling Price and Civil Monetary Penalties (CMP) final rule states that any manufacturer participating in the 340B Program that knowingly and intentionally charges a covered entity more than the ceiling price for a covered outpatient drug may be subject to a Civil Monetary Penalty not to exceed $5,000 for each instance of overcharging.  Assessed CMPs would be in addition to repayment for overcharging.

HRSA stated that it had determined that these policies have resulted in 340B ceiling price overcharges and are in direct violation of the 340B statute. HRSA’s letter states: “[The drug manufacturer] must immediately begin offering its covered outpatient drugs at the 340B ceiling price to covered entities through their contract pharmacy arrangements, regardless of whether they purchase through an in-house pharmacy. [The drug manufacturer] must comply with its 340B statutory obligations and the 340B Program’s CMP final rule and credit or refund all covered entities for overcharges that have resulted from [this] policy.  . . . Continued failure to provide the 340B price to covered entities utilizing contract pharmacies, and the resultant charges to covered entities of more than the 340B ceiling price, may result in CMPs as described in the CMP final rule.”

The full text of the letters can be found by visiting www.hrsa.gov/opa/index.html.

As part of the 2021 statewide protocol update process, the Pennsylvania Department of Health’s Bureau of Emergency Medical Services (EMS) has posted the draft ALS and BLS protocols on its website for public review and comment. The draft documents will remain posted until June 6, 2021. Recommendations for additions/changes, which are not grammatically or formatting in nature, must be supported by medical evidence.  The EMS Information Bulletin 2021-06 can be found at www.pehsc.org