Situation Report | January 18, 2021
As we alerted members last week, Governor Cuomo on January 11 delivered the first part of his annual State-of-the-State address. It was followed — throughout the past week — by subsequent, policy-specific statewide addresses.
Last week’s addresses were, in many respects, a prelude to the release of the Governor’s executive state budget proposal, which is due January 19 and expected any time soon.
In his January 11 address, the Governor laid out a seven-point plan to address COVID-19, vaccinate 70 to 90 percent of New Yorkers, build economic recovery and resurgence, and address systemic injustices to curb inequity, social abuse and racism. As we emphasized in last week’s member alert, the state’s $15 billion deficit permeated the speech.
Without federal aid, the Governor stressed, even “extraordinary measures” like deep education cuts and increased taxes on millionaires would only raise a fraction of the necessary funds. “Even after all that pain,” the Governor said, “we would still need billions in cuts to health care in the middle of a pandemic and we would need to borrow billions at the cost of future generations. It would be devastating to all New Yorkers.”
HCA is also closely examining the Governor’s telehealth proposal, which was mentioned in his State-of-the-State address and posted as a special focus piece on the Governor’s website.
The proposal, as part of the Governor’s Reimagine New York Commission, would do the following:
- Require Medicaid to offer telehealth reimbursement “regardless of where the patient or provider is located in a non-facility setting.”
- Develop interstate licensing reciprocity with states in the Northeast to overcome access shortages in specialties with historical access shortages. Ostensibly, these reciprocity agreements would apply to the use of telehealth platforms, though the Governor’s summary doesn’t explicitly make this connection.
- Continue COVID-era flexibilities for mental health and substance use disorder services.
- Require commercial health insurers to offer a telehealth program to members, and provide Medicaid coverage, subject to federal approval, to cover services furnished telephonically when medically appropriate.
- Ensure that telehealth is reimbursed at rates that incentivize use when medically appropriate.
- Require providers to disclose to patients in writing or through their websites whether they provide telehealth services. Require insurers to provide up-to-date information in their provider directories about which providers offer telehealth services.
- Require insurers to offer members an e-triage or virtual emergency department platform.
- Encourage insurers to reimburse providers directly for engaging in e-consults or permit the inclusion of insurers’ costs associated with e-consult platforms within the health care service costs.
- Streamline the SHIN-NY patient consent process.
- Launch a new telehealth training program and telehealth facilitator pilot.
Home care providers are pioneers of the telehealth model. Telehealth use across all sectors has risen steadily in recent years but was supercharged by the COVID-19 public health emergency. For home care and hospice, specifically, an HCA survey in October found that 22 percent of agencies had a telehealth program before the pandemic. Today, 46 percent of them do. And almost 90 percent of home health and hospice telehealth adopters have increased their use of telehealth in the pandemic.
While many of the Governor’s proposals are promising, HCA awaits further details to learn more. Along with reforms that are supportive of telehealth use in home care and hospice, we will also advocate for appropriate safeguards for patient care quality as well as the jurisdiction of home care and hospice providers in provisioning home telehealth.