DW blog: The First 100 Days


Senate confirms Trump pick for VA secretary

Feb. 14, 2017
The Senate unanimously confirmed David Shulkin, MD, to serve as secretary of the Department of Veterans Affairs. Dr. Shulkin ― trained in internal medicine ― was nominated by President Barack Obama in 2015 to serve as the undersecretary of the U.S Department of Health and Human Services.

In previous media interviews, Dr. Shulkin has indicated that he is in favor of offering a mixed care model for veterans ― where the VA would provide services such as treatment for post-traumatic stress disorder and the private sector would offer veterans other services such as obstetrics and gynecology.

Tentative hearing scheduled for Dr. Price nomination

Jan. 3, 2017
The Senate Health, Education, Labor and Pensions Committee has set a tentative date for a hearing for Rep. Tom Price, MD (R-Ga.) ― President-elect Donald Trump’s pick for Secretary of the U.S. Department of Health and Human Services ― on Jan. 18. However, the hearing date will not be officially announced until one week before it is definitively scheduled to occur. This is would be a courtesy hearing, as it is the Senate Finance Committee that will ultimately vote on the nomination.

The American Academy of Dermatology Association (AADA) has had a long-standing relationship with Dr. Price, who was a featured speaker at the AADA's 2012 Legislative Conference. The AADA has worked with him on issues such as Medicare payment reform, shortening EHR reporting periods, and ensuring that the MACRA transition included opportunities for physicians to avoid penalties.

Similarly, Seema Verma, President-elect Trump’s choice for CMS administrator, can anticipate a confirmation hearing in the near future. Although a date for her hearing has not been publicly floated, the Senate Finance Committee indicates that it has received three years of tax returns and completed questionnaires from both Dr. Price and Verma.

What's next for telemedicine?

Dec. 12, 2016
While traditionally thought of as an issue supported by congressional Democrats, congressional Republicans are increasingly warming to telemedicine as a means to provide health care. Additionally, “Donald Trump has indicated his support of utilizing telemedicine to increase access to care for veterans,” Mathy said. “We’re now seeing more bipartisan work on this issue. The question of whether or not legislation on telemedicine will garner Republican support boils down to cost and budget neutrality.”

So what can be expected from the new Congress in terms of telemedicine legislation? While still unclear, Mathy says that there is hope for some reiteration of the CONNECT for Health Act in the 115th Congress. The legislation ― introduced in the 114th Congress ― would create a volunteer program within Medicare for telemedicine and would allow reimbursement for store-and-forward and live-interactive technology. The AADA has expressed its support for this bill, which reflects the AADA’s position statement suggesting that state licensure law where the patient lives rather than where the physician is located should govern telehealth encounters. “This piece of legislation is the most agreed-upon telemedicine legislation that has garnered support across the aisle. However, “It will all come down to cost, and the Congressional Budget Office (CBO) still has not scored the CONNECT for Health Act.” 

Additionally, in the 114th Congress, there was broad bipartisan support for the CHRONIC Care Act that includes two sections related to telemedicine. “One section would allow Medicare Advantage plans to provide additional telemedicine services as a supplemental benefit,” Mathy said. However, patients would be allowed to choose if they would prefer a telemedicine visit over in-person. “The other section would remove the geographic location requirement in Next Generation Accountable Care Organizations, which would allow chronic care patients to receive services from their home. Currently, the geographic location or originating site has to be a health care office or clinic.” Although it was introduced in the 114th Congress, the CHRONIC Care Act is set to be re-introduced early in the new Congress.

Regardless, Congress and the new Administration will likely have its hands full as it looks to repeal and replace the ACA. “A lot of time in the health care space will be spent on ACA repeal and replacement,” Mathy said. As a result, telemedicine may sit on the back burner until larger issues are addressed.