FCC ADOPTS NEW UNIVERSAL SERVICE RURAL HEALTH CARE RULES
The FCC adopted new rules to improve the universal service program for rural health care providers and increase participation in it, at its meeting Thurs. The order follows FCC Chmn. Powell’s visit to the U. of Va. Office of Telemedicine (CD Nov 10 p3), where he pushed for greater participation in the program to ensure that “the quality of health care available to Americans is not dependent upon their geographic location.” He expressed concern that while the Commission set aside $400 million annually, in the first 5 years of the 6-year-old program barely $30 million was disbursed to rural facilities. In 2000 and 2001, demand for the program averaged $14 million per year -- only 3.5% of available discounts.
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“We now understand that our rural health care program has not lived up to its potential,” Comr. Copps said: “This is not on the scale of what I suspect the Commission had in mind when the program was first set up, and it is certainly not on the scale of what Congress had in mind when it directed the Commission to ensure that health care providers serving rural communities have access to service on par with those available in urban areas.” In the order adopted Thurs., the FCC: (1) Expanded eligible health care providers. (2) Made rural health care providers eligible for discounts of 25% of the monthly cost of Internet access for the first time. (3) Modified calculation of discounted services for more flexibility.
The Commission also revised its policy to allow rural health care providers to receive discounts for satellite services even when alternative terrestrial-based services might be available, capping such discounts at the amounts providers would have received if they had purchased functionally similar terrestrial-based alternatives. “Different technologies may be better suited to different health care providers and the services that they wish to offer,” Comr. Adelstein said: “We should not limit a health care provider’s ability to make that assessment and subsequent choice.” However, he said, “capping the discount at the amount providers would have received if they had purchased functionally similar terrestrial-based alternatives is an important addition to prevent waste, fraud and abuse.”
Telemedicine networks are “integral to our homeland security efforts,” Powell said: “In times of national crisis, telemedicine networks can bring much-needed health care information to first responders.” For example, he said, “telemedicine capabilities serve as a link between medical professional and homeland security teams to ensure that experts are available in the event of a biological or chemical attack.” Copps said the Commission needed to put the program to work “now more than ever because of the heightened threats of bioterrorism and health catastrophe that follow in the wake of 9/11.”
Copps expressed concern that despite the improvements brought about by the changes, “serious problems” remained to keep the program from being utilized the way it should. “Basic lack of outreach and a cumbersome application process may be the real culprits here,” he said: “The rural health care program is only as strong as the community that knows about it. And you know what? A lot of communities don’t know about this program.”
In a further rulemaking notice also adopted Thurs., the FCC asked for comment on providing support to mobile rural health care clinics for satellite services. Comr. Abernathy said she hoped the Commission would “find ways… to fund mobile clinics, such as the satellite-enabled mammography van that Healthcare Anywhere proposes to use to serve women on tribal lands in North and South Dakota.” Abernathy also said in the future the FCC could consider providing additional funding for Internet access. She said the Commission had set the initial discount rate for Internet access at a “modest 25% to prevent excessive fund growth and to ensure that providers have adequate incentives to avoid overpayment.” However, she said: “In time, we may decide that additional funding is warranted, but we must balance the tremendous benefits of telemedicine against the significant burdens that are being placed on consumers to fund our various universal service support mechanisms.” The FCC also asked for comments on the definition of “rural” area.