FCC Urged to Include For-Profit Providers in COVID-19 Telehealth Fund

May 07, 2020 - While the Federal Communications Commission’s COVID-19 Telehealth Program has issued funding to more than 50 healthcare providers, the agency is coming under fire for certain organizations that it’s excluding from the program.

The $200 million program, created from the CARES Act, limits applicants to non-profit entities, as defined by section 254(h)(7)(B) of the Communications Act of 1934. That has drawn complaints from at least two organizations who say many more types of providers – including privately-owned physician practices, many of which are struggling - need help expanding their connected health platforms to deal with the Coronavirus pandemic.

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Last month the American Hospital Association submitted a petition for partial reconsideration to the FCC, calling on the agency to include “all types of hospitals and other direct patient care facilities regardless of their size, location or for-profit or not-for-profit status, including but not limited to rural and urban short-term acute-care, long-term acute care, critical access hospitals and skilled nursing facilities.”

“The Commission’s assertion that restricting participation in the COVID-19 Telehealth Program will ‘ensure that funding is targeted to health care providers that are likely to be most in need of funding to respond to this pandemic while helping us ensure that funding is used for its intended purposes’ is not correct,” Ashley Thompson, the AHA’s senior vice president for public policy analysis and development, said in the latter. “The question of whether a HCP (health care provider) is impacted by the COVID-19 crisis or whether its participation in the COVID-19 Telehealth Program will achieve the goals of the program is in no way affected by the HCP’s status as a for-profit or nonprofit entity.”

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“All HCPs touched by the COVID-19 crisis are affected financially, particularly those that have to shut down regular operations while incurring substantial expenses for supplies, taking care of front line caregivers and building surge capacity,” she added. “HCPs of all stripes are contending with severe supply shortages that materially affect their ability to give proper care to COVID-19 patients. The Commission should not unnecessarily prevent HCPs that may be in the most need of COVID-19 Telehealth Program funding – and best prepared to take advantage of that funding to serve patients – from doing so on the basis of their tax status or ownership structure.”

Now the National Association of Accountable Care Organizations (NAACOS) is joining in, arguing that many doctors work for independent, for-profit practices that don’t qualify for this fund and are in dire need of support.

In a letter sent this week to FCC Chairman Ajit Pai, NAACOS President and CEO Clif Gaus noted that ACOs can apply for the program as a consortium, but that every member of that consortium must be eligible on its own. This rules out any ACO that includes, for instance, just one privately owned practice, small primary care clinic or multi-specialty practice.

According to Gaus, 43 percent of the currently active ACOs are physician-led, and more than 460,000 physicians and other clinicians are taking part in ACOs. And according to a 2018 American Medical Association survey, some 46 percent of those physicians own their own practices.

“During the COVID-19 pandemic, NAACOS has some members whose physician practices are now conducting as many as 90 percent of their patient visits through telehealth,” Gaus said in his letter. “Some are delivering as many telehealth visits in a single day as they did all last year. This dramatic shift is caused by the obvious need to protect the health of non-COVID patients, clinicians and office staff, and minimizing the community spread of the virus by promoting shelter-in-place orders.”

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“While this sudden shift to telehealth has occurred across the health system, NAACOS has heard concerns from ACOs ineligible for the COVID-19 Telehealth Program but who could benefit from the funding,” he added. “The money could help implement the remote monitoring of COVID-19 patients and provide Internet connectivity to support two-way video for disadvantaged patients, for whom ACOs and their participating medical practices are still accountable.”

The AHA and NAACOS aren’t the only ones to raise the issue. Last month, the American Dental Association made its pitch to include dentists in the funding pool, noting they’ve been among the care providers most severely impacted by the COVID-19 crisis.

It remains to be seen whether the FCC will consider expanding the pool, but at least one of the five FCC commissioners is open to it.

In an April 29 tweet, Commissioner Michael O’Reilly noted “not all for-profit hospitals are the same” and said he would be “open to reconsidering” the issue.