Last week, the Federal Communications Commission took steps to review and update its Rural Health Care Program (RHCP) via a Notice of Proposed Rule Making and Order. The item seeks comment on how to improve RHCP, including extending a waiver to allow for the rollover of RHCP funds from Fiscal Year 2017 into mid-2018.
The goal of RHCP has been to improve the quality of health care to patients in rural communities where, according to the National Rural Health Association, only nine percent of the country’s physicians practice. Thus, citizens often face difficulties in getting access to quality health care due to a lack of available professionals.
To help, RHCP covers the costs of broadband service for rural health care providers so that they can communicate with patients miles away, rural clinics can send X-rays to a radiologist in an urban area, provide psychiatric counseling through video conferencing, or even help a woman via video who is struggling with a difficult pregnancy. These types of services need a broadband connection, which may not be available in a particular community.
The RHCP Program was established by the 1996 Telecommunications Act to “facilitate health care delivery in rural and remote parts of America.” The Telecom Program, the Health Care Fund Program, the Internet Access Program, and the Rural Health Care Pilot Program all fall under the umbrella of the RHCP Program
Health care providers in rural America use RHCP in order to, according to the FCC, “provide telemedicine, transmit health records, and conduct other telehealth activities, thereby improving patient care and reducing health care costs.” The program provides eligible health care providers with a 65 percent discount on broadband services in rural America.
The NPRM aims to, “ensure that all communities have access to advanced telehealth services” and “curtail waste, fraud, and abuse” within the program. Chairman Pai said that the FCC will begin working toward that goal by trying to identify the ideal size for RHCP in the future and ways in which the program can function better.
The NPRM raises questions on the following: increasing the spending cap for the program, evaluating the program for fairness and accuracy to establish funding requests, reforming broadband rates, re-defining what “cost-effectiveness” means, ensuring funding for rural and tribal health care providers, simplifying program participation, and enhancing proper oversight of the program.
In particular, the NPRM asks whether a $400 million annual spending cap should be waived on a one-time basis because for – the third year in a row – the spending cap for the program has been exceeded. This would allow previously allotted funds from Fiscal Year 2017 to roll over until mid-2018. The Commission is also seeking comment on whether or not this one-time waiver should be permanently extended.
Finally, the NPRM seeks to gain feedback on how to ensure funding for rural and tribal health care providers and maintaining the participation of rural-urban provider consortia.
The Commission unanimously agreed to evaluate RHCP because, as Commissioner Carr said, “It is important that our rules incentivize the wise and prudent spending of program funds, while ensuring that more Americans, regardless of where they live, have access to advanced telehealth services.” Commissioner Carr also voiced concern that RHCP has seen an increase in funding, while the number of health care service providers using the program has diminished. However, he expressed his support for the Commission to look into updating the program.
Chairman Pai echoed Carr’s sentiments regarding wise and prudent spending, expressing his hope that this proceeding will identify why the program is oversubscribed and offer ideas as to how to tackle the “substantial waste, fraud, and abuse in the program.” He said, “Recent enforcement activity has shown it is all too easy for unscrupulous companies to manipulate the system for their own profit at the expense of the American taxpayer and the rural health care providers that truly need support.”
There were bipartisan expressions of support as Commissioner Rosenworcel said that she backs the NPRM because, “It examines how to future proof the Commission’s Rural Healthcare Program. At the same time, it seeks comment on how to responsibly manage the program budget and, to this end, it asks important questions about prioritization.”
The comment date for this measure has yet to be set.