Senators Seek Extra Federal Funding for Telehealth Services in Frontier States

A group of senators is pushing new legislation that would increase federal funding for telehealth programs in rural states.

The Rural and Telehealth Expansion Act, sponsored by Senators Shelley Moore Capito (R-WV), Jacky Rosen (D-NV), Dan Sullivan (R-AK), Jon Tester (D-MT), Ben Ray Lujan (D-NM) and Lisa Murkowski (R-AK), would boost Federal Medical Assistance Percentage (FMAP) funding by 5 percent for telehealth services – including audio-only telehealth – in frontier states and states with limited broadband access if those states allow Medicaid coverage.

“As we have seen over the past many months, telehealth has the potential to connect those in rural parts of our country with the health care resources they desperately need,” Capito said in a press release. “By incentivizing some of our most rural states and states that still significantly lack access to broadband in many areas … to provide telehealth services for their Medicaid populations, we are taking an important step forward in improving both health care access and health care outcomes.”

The bill is designed to expand connected health services in parts of the country where geography and smaller populations play significant roles in restricting access to healthcare. Along with so-called frontier states, it would include states “where less than 90% of the total population has access to fixed terrestrial broadband service of at least has fixed 25 Megabits per second (Mbps) download and 3 Mbps upload according to the annual Broadband Deployment Report of the Federal Communications Commission.”

The frontier classification for rural states was developed by the US Department of Agriculture’s Economic Research Service (ERS) in partnership with the Federal Office of Rural Health Policy roughly 10 years ago, based on the 2010 census.

According to a policy brief prepared by the National Rural Health Association, the Affordable Care Act was the first policy document to recognize frontier regions, with the Centers for Medicare & Medicaid Services identifying Alaska, Montana, Nevada, North and South Dakota and Wyoming for Medicare reimbursement considerations.

In addition, in 2006 a panel formed by the US Health Resources and Services Administration’s Office for the Advancement of Telehealth created a new definition for frontier: “ZIP code areas whose calculated population centers are more than 60 minutes or 60 miles along the fastest paved road trip to a short-term non-federal general hospital of 75 beds or more, and are not part of a large rural town with a concentration of over 20,000 population.” The panel included in that definition a process to redefine the term or add regions that might qualify as frontiers under different characteristics.

This isn’t the first effort to increase telehealth funding in frontier states. Sullivan filed a bill last year – with companion legislation filed in the House by US Rep Don Young – to make it easier for providers in frontier states to use telemental health platforms.