FCC Adopts Two Telehealth Programs Offering $300 Million to Support Health Care Providers

On April 2, 2020, the FCC released an Order adopting two programs to support telehealth services during the COVID-19 pandemic and over the longer term: 

• The COVID-19 Telehealth Program, which will make $200 million available to help health care providers purchase telecommunications services, broadband connectivity, and devices necessary for providing telehealth services in response to COVID-19; and
• The Connected Care Pilot Program, which will make $100 million available over three years to help defray health care providers’ costs of providing connected care services (e.g., remote patient monitoring, patient health education, “store-and-forward” services, and video consultations and visits), with a particular emphasis on supporting those services for low-income Americans and veterans, and to study the long-term role of connected care services.

Below is an overview of each program and how each eligible health care provider can apply for support.

COVID-19 Telehealth Program

What is the COVID-19 Telehealth Program?

The COVID-19 Telehealth Program implements the provisions of the CARES Act that make $200 million in funding available to the FCC to support health care providers’ use of telehealth services to care for patients with, or at risk of contracting, COVID-19. 

Who is Eligible?

The program is open to nonprofit and public eligible health care providers that fall within the following categories:

• post-secondary educational institutions offering health care instruction, teaching hospitals, and medical schools; 
• community health centers or health centers providing health care to migrants; 
• local health departments or agencies; 
• community mental health centers; 
• not-for-profit hospitals; 
• rural health clinics; 
• skilled nursing facilities; or 
• consortia of health care providers consisting of one or more entities falling into the categories above.

Eligible health care providers that do not already have one will be required to obtain an eligibility determination by filing an FCC Form 460 with the Universal Service Administrative Company (“USAC”) before receiving support (which may occur while an application is pending).

How Much May be Awarded to a Single Applicant? 

The FCC does not specify a limit on how much it will award, but it does not anticipate awarding more than $1 million to any single applicant.  Applicants that have exhausted initially awarded funding may also request additional support.  Applicants that are selected may also submit an application to receive funding from the Connected Care Pilot Program, but may not request funding for the same exact services from both programs. 

What Can the Funds be Used For?

Funds may be used to purchase telecommunications services, information services, and connected devices to provide connected care services in response to COVID-19, including by freeing up resources for health care professionals to treat COVID-19.  Monitoring devices (e.g., pulse-ox and BP monitoring devices) and devices that patients can use at home and then share the results with their health care provider will not be funded unless they are themselves connected.  In addition, funds may not be used for administrative expenses related to participation in the program (e.g., costs for preparing an application) or other miscellaneous expenses (e.g., doctor and staff time spent on program outreach).

When Are Applications Due? 

The FCC will begin accepting applications immediately after publication of the Order and notice of approval by the Office of Management and Budget in the Federal Register.  Funds will be awarded on a rolling basis until the funds are exhausted or the COVID-19 pandemic has ended. 

How to Apply?

Applicants must submit a “COVID-19 Telehealth Program Application and Request for Funding” that includes the following information:

• Description of the anticipated connected care services to be provided, the conditions to be treated, and the goals and objectives
• Description of the estimated number of patients to be treated
• Description of the telecommunications services, information services, or devices (types and uses) requested, the total amount of funding requested, and the total monthly amount of funding requested for each eligible item
• Supporting documentation for the costs listed
• A timeline for deployment and a summary of the factors the applicant intends to track to measure the impact of supported services and devices
• Certifications of compliance with the Health Insurance Portability and Accountability Act (“HIPAA”) and other laws, regulations, policies, and procedures

What are the Selection Processes and Funding Requirements?

The FCC will target funding towards areas that have been hardest hit by COVID-19.  The FCC will evaluate the funding requested by an applicant against the full program budget and will select as many applicants as possible within the budget.  Upon selection, the FCC will provide additional guidance on implementation of the program, including the process for participants to submit monthly invoices and receive reimbursements for their services and devices.  Program participants will be required to maintain records related to their participation for at least three years from the last date of service under the program and present that information upon request. 

Connected Care Pilot Program

What is the Connected Care Pilot Program?

The Connected Care Pilot Program is a longer-term program that would make $100 million in funds available from the Universal Service Fund (“USF”) – an existing fund used to support the provision of telecommunications services where, and to whom, they may not be available – over three years to examine how those funds can help support the trend towards connected care services, particularly for low-income Americans and veterans.  It is unrelated to the relief provided in the CARES Act, but the FCC expects the data derived from the program to assist policymakers and legislators with consideration of broader reforms. 

Who is Eligible?

The program is open to nonprofit and public eligible health care providers that fall within the following categories:

• post-secondary educational institutions offering health care instruction, teaching hospitals, and medical schools; 
• community health centers or health centers providing health care to migrants; 
• local health departments or agencies; 
• community mental health centers; 
• not-for-profit hospitals; 
• rural health clinics; 
• skilled nursing facilities; or 
• consortia of health care providers consisting of one or more entities falling into the categories above.

Eligible health care providers that do not already have one will be required to obtain an eligibility determination by filing an FCC Form 460 with USAC before submitting a pilot project.

Eligible health care providers may receive support for qualifying broadband service from any broadband provider, regardless of whether that provider is designated as an eligible telecommunications carrier, which would typically be required for the use of USF funds.

How Much Will be Awarded to a Single Applicant?

Total available funding under the program may vary year to year depending on the amount of USF funds collected in a year, with unused funds carrying over.  Thus, the funding available for any single project may vary each year.  The FCC does not specify a limit on how much an applicant may request per project, but does not anticipate allocating funds to only one or two large projects. 

What Can the Funds be Used For?

Funding will be provided for selected projects to cover 85% of the eligible costs of broadband connectivity, network equipment, and information services necessary to provide connected care services to the intended patient population.  These costs include:  (i) providing broadband Internet access services (mobile or fixed) to patients who lack or have insufficient access to such services (e.g., low-bandwidth connections, low usage allowances, etc.); (ii) purchasing new or additional broadband data connections for health care providers to provide connected care services; (iii) funding other connected care information services (e.g., “store-and-forward” technologies and remote patient monitoring capabilities, but not costs for medical professional review of transmitted data); and (iv) certain network equipment (e.g., routers and servers).  Funds may not be used for end-user devices or medical equipment.  In addition, funds may not be used for administrative expenses related to participation in the program (e.g., costs for preparing an application) or other miscellaneous expenses (e.g., doctor and staff time spent on program outreach).

Health care providers must contribute the remaining portion of the eligible costs from eligible sources (e.g., the applicant, eligible health care provider, participating patients, or state, federal, or Tribal funding or grants) and cannot use ineligible sources (e.g., direct payments from vendors or service providers) to pay their share of the requested services.

When Are Applications Due? 

Applications will be due 45 days from the effective date of the FCC’s rules, which will occur 30 days after the Order is published in the Federal Register, or 120 days from the release date of the Order, whichever is later.

How to Apply?

Applicants must submit a “Connected Care Pilot Program Application.”  The application requires more detailed information than the application for the COVID-19 Telehealth Program, including, among other things, the following:

• Description of each health care provider’s previous experience with providing telehealth services (other than electronic health records)
• Description of the plan for implementing and operating the project
• Description of the connected care services the proposed project will provide, the conditions to be treated, the health care provider’s experience with treating those conditions, and the goals and objectives 
• Documentation of the health care provider’s financial health (e.g., recent audited balance sheets and income statements that are no more than two years old)
• Description of the estimated number of patients to be treated
• Description of any commitments from community partners to the success of the project 
• Description of the anticipated level of broadband service required
• Description of the estimated number of patient broadband connections that the health care provider intends to purchase
• Estimated total project costs, including eligible and necessary, but ineligible, costs 
• A list of anticipated sources of financial support for costs not covered by the program
• Description of how the health care provider intends to collect, track, and store, the required program date
• Description of whether the project will primarily benefit low-income or veteran patients
• Certifications of compliance with HIPAA and other laws, regulations, policies, and procedures

What are the Selection Processes and Funding Requirements?

Funding will be targeted to projects that can demonstrate they will primarily benefit veterans or low-income individuals.  The FCC will have a strong preference for health care providers that have either (i) experience with providing telehealth or connected care services to patients (beyond using electronic health records), or (ii) a partnership with another health care provider, government agency, or designated telehealth resource center with such experience.  The FCC does not set a limit on the number of projects it will select, but will evaluate the funding requested by an applicant against the full program budget.

Once selected and prior to requesting funding, program participants will be required to conduct a procurement process to solicit and select eligible services and/or equipment.  To request funding, participants will be required to submit a Request for Funding to USAC no later than six months after the selection date.  After providing the eligible services and/or equipment, service providers and program participants will be required to make certain certifications and submit invoicing forms on a monthly basis to receive reimbursement for the cost of the eligible services and/or equipment. 

Support will be provided for three-years, with separate transition periods of up to six months before and after the three-year funding period to give pilot projects time to complete set up, close out, and address other administrative matters.  Program participants will be required to submit periodically anonymized, aggregated data to the FCC regarding their project after each year of funding and final reports within six months of the end dates of their projects.  The FCC will determine at a later date the specific data to be reported and the format of the required data as well as provide further information on other requirements, including, but not limited to, the requirements for requesting funding, invoicing, and programmatic safeguards (e.g., document retention and audit requirements).

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