FCC Hears of Rural Healthcare Rate and Other Concerns From AT&T, GCI and SHLB
GCI Communication asked the FCC to reconsider a public notice that "purports" to give providers rate guidance for the USF rural healthcare telecom program (see 1902190031). The Wireline Bureau's Feb. 15 PN "entirely disregards detailed, on-the-record objections to which the Commission is legally obligated to respond and which show the guidance to be irrational and counterproductive, ignoring relevant evidence of market-based prices," petitioned GCI, posted Tuesday in docket 17-130: "It will be vulnerable on judicial review." Alaska Communications last week said the PN guidance "appears to overlook ... pragmatic realities" (see 1903140062).
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Others cited overall RHC program concerns. There's "consensus" that "robust competition could address much of the waste, fraud and abuse," but competitive barriers exist, including lack of detailed healthcare provider information in advance about the services sought, filed AT&T on meeting bureau staffers, also posted Tuesday. RHC "has not operated smoothly for several years," filed the Schools, Health & Libraries Broadband Coalition Friday. "Many of our members now believe the problems are worse than ever." It called for "emergency action" to restructure program administration. The FCC didn't comment Tuesday.
The bureau rate guidance "fails to provide enough information to allow a healthcare provider ('HCPs') or service provider to determine permissible rates, but does (as has already happened in Alaska) often bar program participants from relying on the best evidence of such rates -- the market rates for their services," GCI said. "That will force service providers to conduct time-consuming and unreliable cost studies, which will in turn decrease carrier participation and thus increase RHC Program costs." The PN "finds that 'comparable' rates charged to non-HCP customers are only those reflecting the entire charge for the same service configuration, 'end-to-end,'" the Alaska carrier said. "But there is no logical reason why market comparables for components cannot demonstrate a reasonable, market-based rate for the entire circuit, absent direct end-to-end comparables." It said the PN disregards volume and term discounts and technology, doesn't address "what costs would be considered permissible or impermissible," and "lacks any discussion of the permissible rate of return."
Universal Service Administrative Co. "essentially revived long obsolete" Form 468, in "faithfully and aggressively implementing" the bureau guidance, said AT&T. The FCC and USAC "wisely" jettisoned the Form in 2002 due to complaints about funding delays, said the telco. It noted barriers to competition that could otherwise help discipline rates, including: "Prospective service providers do not receive enough information about the services [HCPs] are requesting ... based on how HCPs or their consultants have been filling out FCC Form 465." AT&T urged requiring HCPs to provide more specificity about their existing RHC-backed services or those they want -- which it said would reduce consultants' "gatekeeper" role -- and to make price the primary factor in considering bids.
SHLB said the program "suffers" from "operational and policy problems" that discourage participation by all providers, including processing delays, transparency concerns and "shifting" application reviews. "These problems are causing harm to patients in rural and underserved markets," SHLB said. Its dozen proposals include: completing processing of all pending applications by April 30, increasing USAC-RHC staff, giving applicants in advance "a complete listing (checklist)" of all documentation USAC reviewers will seek, extending a May 31 deadline for funding year 2019 applications by a month, and completing a rulemaking answering all open questions on the RHC telecom program and the healthcare connect fund.