Telehealth Integration

LUGPA is dedicated to advancing the permanent integration and expansion of telehealth to enhance patient care. Our goal is to promote a reimbursement model that encourages meaningful provider adoption and technological adaptations necessary for a sustainable telehealth infrastructure.

Key Objectives

Permanent Telehealth Integration: Work towards the lasting incorporation of telehealth into regular healthcare delivery.
Reimbursement Model: Advocate for a reimbursement framework that supports technological advancements and ensures telehealth infrastructure is robust and enduring.

Telehealth's Role During COVID-19

Telehealth played a vital role in maintaining healthcare access during the COVID-19 pandemic. Regulatory changes allowed for its rapid expansion and improved patient access. However, some beneficial changes, such as telehealth payment parity and cross-state licensing, have expired post-pandemic.

LUGPA supports bipartisan legislation to make these expansions permanent, as they are crucial for independent urologists. Continued coverage and reimbursement flexibility enable urologists to provide high-quality, geographically unrestricted care. Payment parity ensures financial stability for providers, while expanded telehealth coverage improves access, particularly in rural areas.

Telehealth Post-Pandemic

As telehealth remains integral to healthcare delivery, policymakers must modernize regulatory frameworks to ensure equitable access for all patients. LUGPA will continue monitoring Congress for reforms affecting telehealth and help our members integrate these services into their practices.

Extensions and Legislative Efforts

Several telehealth coverage expansions from the pandemic have been extended:

Expansion of Originating Sites: Medicare beneficiaries can receive telehealth services from any location, including their homes.
Expansion of Eligible Practitioners: More providers can offer telehealth services, including therapists and audiologists.
Telehealth Services and Reimbursement to FQHCs and RHCs: Continued Medicare reimbursement for telehealth services.
Delay of Periodic In-Person Visit Requirement for Mental Health Services: Postponed requirement for in-person visits before telehealth services.
Expansion of Audio-Only Services: Medicare covers audio-only services when appropriate.

The Consolidated Appropriations Act (CAA) extended many telehealth flexibilities through December 31, 2024, with a report on telehealth use due by April 2026.

Cross-State Licensing and Rural Access

During the PHE, many states temporarily waived aspects of state licensure requirements, allowing providers to offer telehealth across state lines. The future of these waivers varies by state. LUGPA supports making these waivers permanent to enhance care access, especially in rural areas.

LUGPA’s Recommendations for Regulatory Reform

Remove Geographic and Originating Site Restrictions: Expand the definition of “originating site” to any location where the patient is during the telehealth service.
Maintain Reimbursement Rates for Telehealth Visits: Keep telehealth visit reimbursements at E&M payment rates.
Require Reimbursement Parity for Telehealth Services: Ensure insurers reimburse telehealth services at the same rate as in-person care.
Remove Coverage Limits for Asynchronous Telehealth: Allow Medicare to cover store-and-forward telehealth at the same level as video conferencing.

Healthcare Technology, Security, and Data

LUGPA recognizes the importance of integrating advanced technology while ensuring security and data privacy.

Artificial Intelligence (AI) in Healthcare

AI is revolutionizing healthcare by enhancing diagnostic accuracy, treatment planning, and overall patient care. In urology, AI-powered tools improve diagnostic precision and enable personalized treatment strategies. However, integrating AI requires revisiting reimbursement policies to ensure fair compensation and standardizing training programs to maintain care quality.

AI Regulatory Landscape

Legislative Initiatives: Several bills address AI use, focusing on bias elimination, risk management, and ensuring safety.
Executive Order on AI: Promotes safe, secure, and trustworthy AI development.
FDA’s Role: Adapting procedures to evaluate AI algorithms in medical devices.

LUGPA advocates for clear regulatory guidelines that balance innovation with patient safety, ensuring responsible AI integration in healthcare.

LUGPA remains committed to advancing telehealth and AI integration in urology. By supporting regulatory reforms and advocating for sustainable reimbursement models, we aim to enhance patient care, improve access, and ensure the long-term viability of telehealth services.

Links to LUGPA Resources

LUGPA Policy Update - Expected DEA Extension of Telemedicine Prescribing Flexibilities Through 2025 - November 4, 2024

Recent Developments in Telehealth Regulation - May 2024

Improving Cybersecurity for Healthcare Providers - page updated in 2024

Advancing AI in Healthcare - May 2024

Cybersecurity Threats in Healthcare on the Rise - March 2024

Data Privacy and Health Information Exchange in Urology - Dec. 2023

Medicare Inpatient-Only List - Nov. 2023

Telehealth Post-Pandemic LUGPA Update - April 2023

LUGPA Advocates for Reforms to Protect Access to Telehealth - July 2024

CMS’s TEAM Medicare Funding Proposal - April 2024