By Anuja Vaidya
The Federal Communications Commission plans to change how payment rates are determined for rural providers using telecommunications, including telehealth.
The Rural Health Care Programme assists rural healthcare providers with the cost of broadband and other communications services. It includes the Telecommunications (Telecom) Programme, which subsidizes the difference between urban and rural rates for telecommunications services, and the Healthcare Connect Fund (HCF) Programme, which promotes broadband services and facilitates the formation of healthcare providers consortia.
The FCC is seeking comment on potential revisions to the rates database for the Telecom Programme.
Adopted in 2019, the rates database lists eligible services in the programme, median urban and rural rates for services by state, and underlying rate data used to determine the median rates. But the use of the database was waived in funding years 2021 and 2022 due to “anomalies and inconsistencies,” according to the FCC.
Now, the FCC is asking for comment on how best to fix those anomalies, which include examples of lower median rates in more rural tiers as compared with less rural tiers. Rural tiers are groupings of comparable rural areas based on the provider’s location relative to the Census Bureau’s Core Based Statistical Area designation.
“These anomalies raise questions about whether the rurality tiers based on Core Based Statistical Areas accurately group comparable rural areas for purposes of determining telecommunications rates,” the FCC stated in its proposed rulemaking factsheet.
Further, the agency proposed alternative rate determination mechanisms. One alternate method involves creating a nationwide regression model to estimate rural and urban rates and determine Telecom Programme reimbursement on a state-by-state basis.
The FCC also proposed plans to improve reporting requirements and data quality for the Rural Health Care Programme. The agency plans to revise forms for the programme to allow for more detailed service information collection that can enable more accurate comparisons of rates for similar services.
In addition, the FCC plans to reform its funding cap rules governing the internal cap on multi-year commitments and upfront payments in the Healthcare Connect Fund Programme. The agency’s proposed change would have the internal cap apply only when overall demand exceeds available funding. In cases where it does apply, the internal cap would target funding for equipment and services needed in the funding year at issue.
Finally, the commission proposed fully harmonizing the invoicing process between the Telecom Program and the Healthcare Connect Fund Programme. Currently, there are separate invoicing processes for the two programmes.
The proposed changes come amid efforts to increase access to broadband across the country.
Last November, the FCC announced plans to authorize more than US$700 million in funding to broadband providers to boost internet connectivity in rural areas.
More recently, the agency provided US$47.89 million to 100 healthcare organizations to boost telehealth services during the COVID-19 pandemic.
Providers are using these federal funds in various ways, including purchasing telemedicine carts and monitors and increasing access to remote monitoring solutions.
