DOH Regulatory Modernization Report Outlines Recommendations for Post-Acute Care Management and Telehealth
The Department of Health (DOH) released a report on the findings of five work groups convened last year under the auspices of the Department's Regulatory Modernization Initiative (RMI). Of particular interest to LeadingAge NY members is the report's summary of the recommendations made by the Post-Acute Care Management and Telehealth Work Groups and the actions to be taken by the Department in response.
LeadingAge NY and several of its members participated in the Post-Acute Care Management Work Group (the PACM Work Group), and we were pleased to see our advocacy efforts achieve results. In response to the input of LeadingAge NY and other stakeholders, the Department has issued guidance on the hospital-physician-home care collaborations authorized under section 2805-x of the Public Health Law. LeadingAge NY successfully advocated for the inclusion of providers across the long-term/post-acute care (LTPAC) continuum (e.g., home care agencies, adult day health care, nursing homes, and hospice) in these collaborations. In addition, LeadingAge NY, through the PACM Work Group and other venues, has continued to press for funding for LTPAC providers to support health information technology, health information exchange, and telehealth. As the report notes, the Governor's proposed budget dedicated funding for LTPAC providers for capital, health information technology, and telehealth purposes. We also sought the elimination of the Patient Review Instrument (PRI) as a prerequisite for nursing home admission. According to the report, the Department agrees that the PRI is obsolete and will issue a Request for Information seeking a replacement for the PRI.
The PACM section of the report also includes recommendations to provide legal authority for community paramedicine programs and to offer general education on advance care planning, hospice, and palliative care. The report notes LeadingAge NY's proposal to allow nurses to practice nursing in assisted living facilities and acknowledges that this limitation can lead to avoidable hospitalizations. However, the Department indicates that the PACM Work Group did not reach a consensus to adopt this proposal.
The Telehealth Work Group's recommendations were also included in the report. These recommendations include an expansion of the permissible originating sites for telehealth services to allow the delivery of various telehealth modalities in patient's homes, as well as remote patient monitoring. The report also recommends an expansion of the authorized providers of telehealth services. In addition, the report indicates that the Department will issue guidance to clarify telehealth reimbursement under Medicaid and has implemented a process for Medicaid managed care plans to submit telehealth innovation plans to secure approval of telehealth services "in lieu of" other covered benefits.
The report sets forth the recommendations of three additional work groups:
- Integrated Primary Care and Behavioral Health
- Cardiac Services
- Telehealth
- Off Campus Emergency Departments.
The recommendations of the final work group – Long-Term Care Need Methodologies – have not been finalized.
Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8383 ext. 124