Yesterday, the Health Resources and Services Administration (HRSA) published a new informative Program Assistance Letter (PAL) regarding telehealth and its intersection with the Health Center Program scope of project.

In the PAL, HRSA recognizes that telehealth is “a rapidly changing area of health care that will impact Health Center Program policy over time” and that health centers “are increasingly using telehealth as a means of delivering comprehensive primary care services to health center patients.”

Although HRSA supports the use of telehealth to enhance patient access and early intervention, it recognizes that the use of telehealth also involves complex issues relating to, among others, provider licensure, informed consent, fraud and abuse laws, the corporate practice of medicine, standard of care, and liability concerns. Accordingly, in the PAL, HRSA “strongly encourages” health centers that provide (or are planning to provide) health services via telehealth to consult with professional organizations, regulatory bodies, and private counsel to help assess, develop, and maintain written telehealth policies that comply with applicable Health Center Program requirements; Federal, State, and local requirements; and applicable standards of practice. The PAL further includes a detailed table (pp. 5-6) that specifies, for purposes of services furnished via telehealth, how health centers would accurately reflect sites, services, and service delivery methods in a health center’s scope of project.

It is critical that health centers that provide (or are planning to provide) health services via telehealth closely review the chart as it includes important information which may impact whether certain telehealth arrangements can, in fact, be included within the health center’s scope of project.  For example, the chart specifies that if a patient is at a location that is not an in-scope service site, yet the provider furnishing services via telehealth is at an in-scope service site, then the health center must ensure, among other things, that individuals receiving the service via telehealth are established health center patients and have reasonable access to the health center’s full scope of services.

Additional highlights from the PAL include the following:

• The PAL clarifies that “telehealth” is not a service or a service delivery method requiring specific HRSA approval; rather, telehealth is a mechanism or means for delivering a health service(s) to health center patients using telecommunications technology or equipment. HRSA does not require health centers to seek prior approval from HRSA for a change in scope to use telehealth or separately record the use of telehealth as the means by which an in-scope service is delivered.
• The PAL lists a range of issues that would support successful implementation of telehealth, including but not limited to considerations applicable to provider licensure, privacy/confidentiality, patient consent, billing and third-party payments, and liability coverage.
• The PAL specifies that locations where patients are located and all services are exclusively delivered via telehealth would not meet the “face-to-face” criterion of the service site definition and therefore, would not be considered service sites under PIN 2008-01 and would not be listed as service sites on Form 5B.

Questions? If you have questions about this Client Alert or other matters related to telehealth and health centers more generally, please contact Carrie Riley, or call FTLF at (202) 466-8960.

Webinar: On March 26, 2020 at 1 PM ET, FTLF is hosting a webinar exploring the intersection of telehealth and scope of project, and providing recommended tips for developing a compliant telehealth policy. Learn More or Register Here.