TR Daily Input Sought on Metrics for COVID-19 Telehealth Applications
Wednesday, January 6, 2021

Input Sought on Metrics for COVID-19 Telehealth Applications

The FCC’s Wireline Competition Bureau today requested comment on metrics for evaluating applications for funding under the COVID-19 Telehealth Program, as the agency prepares to disburse nearly $250 million in second round funding for the program that was appropriated in the coronavirus response and relief provisions of the Consolidated Appropriations Act of 2021.

Congress created the COVID-19 Telehealth Program earlier this year in the Coronavirus Aid, Relief, and Economic Security (CARES) Act with $200 million to support telehealth and connected services for patients at home or on the move outside of medical care settings.

The FCC allocated all of the first-round funding from the CARES Act by July, "targeting applications from providers in the hardest hit areas that would have the greatest impact on the pandemic. However, demand for the program significantly exceeded available funding," the bureau said today in a public notice in WC docket 20-89.

The recently enacted fiscal year 2021 appropriations and COVID-19 relief package included additional funding for the COVID-19 Telehealth Program, part of $7 billion for various broadband programs (TR Daily, Dec. 22, 2020).

In today’s public notice, the bureau said that, in addition to appropriating $249.95 million for the telehealth program, the Consolidated Appropriations Act "requires the Commission to seek comment on ‘the metrics the Commission should use to evaluate applications for funding’ and ‘how the Commission should treat applications filed during the funding rounds for awards from the COVID-19 Telehealth Program using amounts appropriated under the CARES Act . . . .’ Through this Public Notice, we seek comment on these matters, as well as how to meet the Act’s other requirements for the COVID-19 Telehealth Program and other improvements to the application, review, and invoicing process."

The bureau noted that the Act "directs the Commission, to the extent feasible, to ensure an equitable distribution of funding by awarding funding to at least one applicant in each of the 50 states and the District of Columbia. Additionally, the Act requires the Commission to allow an applicant who filed an application during Round 1 of the COVID-19 Telehealth Program ‘the opportunity to update or amend that application as necessary.’"

The bureau asked if it should "continue to target funding to health care providers in areas ‘hardest hit’ by COVID-19 at the time of the funding decision," as it did during the first round of funding. "Given the broader infection rate currently in the U.S., should we continue to target funding to hardest hit areas? If so, how should we define which areas have been ‘hardest hit’?" it asked.

"Similarly, in Round 1 the Commission targeted funding to health care providers under pre-existing strain. … However, given the longevity of pandemic, many health care providers throughout the country have experienced significant strain. In Round 2, what weight should we give pre-existing strain faced by applicant health care providers? Should we distinguish pre-existing strain from pandemic-related strains many providers now face?" it asked.

It asked whether it should maintain the $1 million per applicant limit used in the first round, and how it should "address applications filed by statewide entities, large health care providers or health care provider systems with numerous sites."

It asked whether recipients of first-round funding should be eligible for funding from the second round, and whether additional funding should be available to first-round recipients that received $1 million.

"Are there any other metrics we should use to prioritize applications during the evaluation process? Should we prioritize health care providers serving a large percentage of COVID-19 patients? Are there specific types of telehealth and connected care services that should be prioritized? Should we prioritize applications from health care providers that seek funding to treat specific at-risk populations, such as Tribal, low-income, or rural communities? If so, how should those populations be defined? Should these applicants be prioritized only if a certain percentage of their patient base, i.e., the total amount of patients who visited a facility in a year, is at-risk? What percentage would be reasonable to achieve the goal of prioritizing funding for at-risk populations? Are there other criteria we should prioritize?" it asked.

In order to fulfill the Act’s directive to make at least one award in each state and the District of Columbia, the bureau proposed using a filing window, rather than conducting the application process on a rolling basis as it did in Round 1, so as to allow the bureau "to prioritize applications using pre-defined evaluation metrics and ensure that funding is provided, to the extent feasible, to at least one applicant in each of the 50 states and the District of Columbia. This approach would also provide all applicants the same period of time to prepare and file applications. We seek comment on this approach. If an application filing window is established, how long should the window remain open?" it asked.

The bureau proposed requiring Round 1 applicants that want to be considered in Round 2 to update and resubmit their applications. It noted that the new application portal will seek additional information needed to comply with the Consolidated Appropriations Act.

It also proposed using the Universal Service Administrative Co. "to assist in administering the remaining work necessary to complete Round 1 of the Programs as well as Round 2."

The bureau noted that "requiring health care providers to file FCC Forms 460 [to determine eligibility] for each site delayed our ability to move quickly on many applications, especially those applications with a large number of sites in need of eligibility determinations. Using a different method to determine whether a site is eligible could reduce the administrative burden on applications, the Commission, and USAC during the application review process. Accordingly, we seek comment on directing USAC to include eligibility review as part of the application process, but not requiring applicants to file FCC Forms 460. Are there other means of identifying health care providers and determining their eligibility for support in the program that we should consider?"

It asked for comment on whether there are "additional improvements we should consider making to the application, review, and invoicing processes" and whether it should maintain the flexibility allowed in the first round for applicants to "substitute vendors, eligible services, and/or eligible connected devices as long as the substituted items are eligible and the total amount sought for reimbursement does not exceed the commitment amount."

Comments on the issues raised in the public notice are due Jan. 19.

FCC Chairman Ajit Pai said, "Telehealth has been a critical factor in helping us address the COVID-19 pandemic, which continues to have a devastating impact on the health of the American people. Last year, the FCC quickly stood up its COVID-19 Telehealth Program, allocating the full $200 million provided in the CARES Act to worthy telehealth projects across the country. We have already seen the program’s positive impact on expanding access to telehealth services across the country, from health clinics providing bi-lingual telehealth services to rural hospitals connecting with record numbers of remote patients. I’m pleased that this new support from Congress will enable us to extend this program into 2021. I am confident that our team at the Commission will work expeditiously to provide additional support for telehealth services through Round 2 of the program."

Commissioner Brendan Carr, who spearheaded the FCC’s own, separate Connected Care telehealth initiative over the past two years, said, "The delivery of high-quality care is no longer limited to the confines of traditional brick-and-mortar facilities. With smartphones and other connected devices, Americans can now access health care services right from their homes or anywhere they have an Internet connection. FCC staff have worked tirelessly to support this new trend in care, and the agency’s work to stand up the FCC’s COVID-19 Telehealth Program has been part of those efforts. Congress has recognized that delivering care at a distance is part of the bright future for telehealth. And it has now authorized an additional $250 million for the FCC to allocate through a second round of this successful program."

He added, "I have had the chance to meet with many of the health care heroes that received Round 1 funding, and the FCC’s Telehealth Program provided them with critical support as they saw demand for telehealth services skyrocket in the wake of COVID-19. I look forward to working with my FCC colleagues as we launch a second round of this successful initiative."

Commissioner Jessica Rosenworcel said, "With over 20 million cases of this cruel virus in the United States, this pandemic has taken a toll on our healthcare system. So it is good news that Congress has provided new resources for the Federal Communications Commission to help by expanding opportunities for telehealth. Today, the agency gets this process started by seeking comment on how it should award funds to assist with connectivity for remote patient care and monitoring in the COVID-19 Telehealth program. This effort is timely, given the crisis before us, and it demonstrates just how important it is to get 100% of us connected." —Lynn Stanton, [email protected]

MainStory: FederalNews FCC BroadbandAdoption Covid19

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