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Dị ka Ngalaba Ahụike na Ọrụ Ndị Ọrụ (HHS ma ọ bụ Ngalaba) na-aga n'ihu na usoro mgbanwe site na iwu mberede COVID-19, Ngalaba ahụ chọrọ ịkọwapụta telehealth gọọmentị etiti n'ọdịnihu na mgbanwe njikwa anya iji hụ na ndị ọrịa nwere ike ịga n'ihu na-anata ma nweta enyemaka ha. mkpa.N'okpuru ebe a bụ akwụkwọ akụkọ na-akọwa ihe ga-agbanwe maka ndị ọrịa na ndị na-ahụ maka ahụike mgbe onye odeakwụkwọ HHS kwupụtara Mberede Ahụike Ọha (PHE) maka COVID-19 dabere na Nkebi 319 nke Iwu Ọrụ Ahụike Ọha (lee n'okpuru) ), nke ga-anọgide na-agbanwe agbanwe. dị ka "COVID".-19 PHE).PHE kwụsịrị.Congress gafere Omnibus Appropriations Act nke 2023, na-agbatị ọtụtụ n'ime atụmatụ ahụike ahụike mgbanwe mgbanwe telehealth nke ndị mmadụ na-adabere na ya n'oge PHE COVID-19 site na njedebe nke 2024. HHS iji kesaa ntuziaka ndị ọzọ maka mmelite na oge njedebe metụtara ịnọgide na-enwe mgbanwe ndị a na mgbakwunye, Health Resources and Services Administration (HRSA) na-arụ ọrụ weebụsaịtị HHS www.Telehealth.HHS.gov, nke ga-aga n'ihu na-eje ozi dị ka ihe enyemaka maka ndị ọrịa, ndị na-ahụ maka ahụike na steeti maka ozi telemedicine dị ka telemedicine kacha mma omume, mmelite amụma. na nkwụghachi ụgwọ, ikikere interstate, ohere brọdband, ohere ego, na mmemme.
Medicare na Telehealth N'oge PHE, ndị nwere Medicare nwere ohere sara mbara na ọrụ telehealth, gụnyere n'ụlọ ha, na-enweghị njedebe mpaghara ma ọ bụ ebe ọ bụla n'ihi na onye odeakwụkwọ nke ntinye ego na-enye mgbakwunye na nkwado nkwado na nzaghachi nzaghachi maka Telemedicine 2020 na Coronavirus.Iwu enyemaka, enyemaka na nchekwa akụ na ụba.Telemedicine na-agụnye ọrụ ndị a na-enye site na usoro mgbasa ozi dị ka kọmputa ma na-enye ndị na-ahụ maka ahụike ohere nlekọta ahụike nye ndị ọrịa n'ebe dị anya kama ịnọ n'ụlọ ọrụ.Iwu kwadoro nkwado nke 2023 na-agbatị ọtụtụ mgbanwe mgbanwe telemedicine nke Medicare ruo na Disemba 31, 2024, dị ka:
Na mgbakwunye, mgbe Disemba 31, 2024 gachara, mgbe mgbanwe ndị a ga-agwụ, ụfọdụ ACO nwere ike ịnye ọrụ telehealth, na-ekwe ka ndị dọkịta na-ekere òkè ACO na ndị ọrụ ahụike ndị ọzọ na-elekọta ndị ọrịa na-enweghị nleta onwe onye, ​​n'agbanyeghị ma ebe ha bi.Ọ bụrụ na onye na-ahụ maka ahụike na-esonye na ACO, ndị mmadụ kwesịrị ịlele ha ka ha chọpụta ihe ọrụ ekwentị nwere ike ịdị.Atụmatụ uru Medicare ga-ekpuchirịrị ọrụ telehealth nke Medicare kpuchiri ma nwee ike ịnye ọrụ ekwentị ọzọ.Ndị mmadụ n'otu n'otu debanyere aha na atụmatụ uru Medicare kwesịrị iji atụmatụ ha lelee mkpuchi ekwentị ha.
Steeti nwere Medicaid, CHIP, na Telehealth nwere mgbanwe dị ukwuu na mkpuchi Medicaid na mmemme mkpuchi ahụike ụmụaka (CHIP) enyere site na telehealth.Dị ka nke a, mgbanwe mgbanwe telemedicine dịgasị iche site na steeti, yana ụfọdụ kegidere na njedebe nke COVID-19 PHE, ụfọdụ jikọtara ya na ọkwa PHE steeti na ihe mberede ndị ọzọ, yana ụfọdụ mmemme Medicaid na CHIP steeti nyere ogologo oge tupu ọrịa a.Mgbe nchupu nke atụmatụ PHE gọọmenti etiti, Medicaid na CHIP iwu telehealth ga-aga n'ihu na-adị iche site na steeti.Ụlọ ọrụ maka Medicare na Medicaid Services (CMS) na-agba ndị steeti ume ka ha gaa n'ihu na-akwụ ụgwọ maka Medicaid na CHIP ọrụ ndị a na-enye site na telehealth.Iji nyere steeti aka n'ịga n'ihu, ịnakwere, ma ọ bụ ịgbasa mkpuchi telehealth na amụma ịkwụ ụgwọ, CMS ewepụtala Medicaid State na CHIP Telehealth Toolkit, yana akwụkwọ agbakwunyere na-akọwapụta isiokwu amụma nke kwuru kwesịrị ikwu okwu iji kwalite nnabata telehealth: https:// www.medicaid.gov/medicaid/benefits/downloads/medicaid-chip-telehealth-toolkit.pdf;
Insurance Health Insurance and Telemedicine Dị ka ọ dị ugbu a n'oge PHE COVID-19, ozugbo PHE COVID-19 kwụsịrị, mkpuchi maka telemedicine na ọrụ nlekọta anya ga-adịgasị iche site na atụmatụ mkpuchi nkeonwe.Mgbe a bịara na telemedicine na ọrụ nlekọta anya ndị ọzọ, ụlọ ọrụ ịnshọransị nkeonwe nwere ike itinye oke ọnụ ahịa, ikike tupu oge, ma ọ bụ ụdị nlekọta ahụike ndị ọzọ nke ọrụ dị otú ahụ.Maka ozi ndị ọzọ gbasara ụzọ onye inshọransị si aga telemedicine, ndị ọrịa kwesịrị ịkpọtụrụ nọmba ọrụ ndị ahịa insurer nke dị n'azụ kaadị mkpuchi ha.
N'oge PHE COVID-19, na nke mbụ, ndị na-ahụ maka ahụike nọ n'okpuru Iwu Nzuzo HIPAA, Nchekwa, na Iwu Mmebi (Iwu HIPAA) na-achọ ka gị na ndị ọrịa kparịta ụka ma nye ọrụ telehealth site na iji teknụzụ nkwurịta okwu dịpụrụ adịpụ nke nwere ike. aghọtabeghị nke ọma.HIPAA kwekọrọ chọrọ.HHS Office of Civil Rights (OCR) ekwuputala na ka ọnwa Maachị 17, 2020, ọ ga-egosipụta ezi uche ya na ọ gaghị etinye ntaramahụhụ n'ahụ ndị na-ahụ maka ahụike na-anaghị agbaso iwu HIPAA.Ndị na-enye ndị na-eji teknụzụ nlebanya anya ọ bụla nwere ike iji ha na-enweghị ihe egwu nke a ga-ata OCR ntaramahụhụ maka adịghị erube isi na iwu HIPAA.Nzube a metụtara ọrụ telemedicine enyere maka ebumnuche ọ bụla, ma ọrụ telemedicine metụtara nyocha na ọgwụgwọ nke ọnọdụ ahụike metụtara COVID-19.
Na Eprel 11, 2023, OCR kwupụtara na n'ihi njedebe nke PHE COVID-19, ọkwa mmanye a ga-agwụ na Mee 11, 2023 na 11:59 ehihie.OCR ga-aga n'ihu na-akwado iji telemedicine mgbe PHE gasịrị site n'inye ndị na-ahụ maka nlekọta ahụike kpuchiri ekpuchi oge mgbanwe nke ụbọchị 90 iji mee mgbanwe ọ bụla dị mkpa na ọrụ ha iji nye telemedicine n'ụzọ nzuzo na nchekwa dịka ihe achọrọ nke iwu ahụike HIPAA. .N'ime oge mgbanwe a, OCR ga-aga n'ihu na-amanye ikike ya ma ọ gaghị ata ndị na-ahụ maka nlekọta ahụike kpuchiri ụgwọ maka ịghara irube isi n'iwu HIPAA Telemedicine Fair Practice.Oge mgbanwe ga-amalite na Mee 12, 2023 wee kwụsị na Ọgọst 9, 2023 na 23:59.
Maka ozi ndị ọzọ, biko gaa na webụsaịtị OCR maka ọkwa njedebe maka ụfọdụ ọkwa mmanye enyere n'ihi ihe mberede ahụike ọha na eze COVID-19.
Ahụike Telebehavioral na Mmemme Ọgwụgwọ Opioid Kemgbe mmalite nke PHE, HHS Substance Abuse and Mental Health Services Authority (SAMHSA) ewepụtala ntuziaka mgbanwe mgbanwe maka mmemme ọgwụgwọ opioid dị iche iche (OTPs) iji nyere aka dozie mmetụta ahụike nke ịpụpụ mmadụ na OTP na ndị ọrịa ya. ..
Nlele nyocha ahụike nkeonwe: SAMHSA na-ewepụ ihe OTP chọrọ maka nyocha ahụike saịtị maka onye ọrịa ọ bụla ga-anata OTP buprenorphine, ma ọ bụrụhaala na mmemme Mkpebi Dọkịta na-enyocha dibịa mmemme, dibịa na-ahụ maka nlekọta mbụ, ma ọ bụ ọkachamara ahụike ikike.Enwere ike iji telemedicine mee nyocha zuru oke nke ọnọdụ onye ọrịa.SAMHSA ekwuputala na a ga-agbatịkwu mgbanwe a site na Mee 11, 2024. Mgbatị ahụ ga-amalite na Mee 11, 2023, na SAMHSA na-atụkwa aro ime mgbanwe a na-adịgide adịgide dị ka akụkụ nke Ọkwa nke Iwu Iwu, nke a ga-ebipụta na December. 2022.
Usoro ọgwụgwọ ụlọ: Na Machị 2020, SAMHSA nyere akwụkwọ ikike OTP, n'okpuru nke steeti nwere ike ịchọ “nnwere onwe maka ndị ọrịa niile kwụsiri ike na OTP ịnata ihe ruru ụbọchị 28 nke ọgwụ opioids n'ụlọ.Ọgwụ maka ọgbaghara iji ihe eji eme ihe.Steeti nwekwara ike "chọọ ruo ụbọchị iri na anọ nke ọgwụ ụlọ maka ndị ọrịa na-esiwanye ike mana ndị OTP kpebiri nwere ike ijikwa ọkwa ọgwụ ụlọ a n'enweghị nsogbu."
N'ime afọ atọ kemgbe anabatara nkwụsị a, steeti, OTP, na ndị ọzọ metụtara akọpụtala na ọ butere mmụba nke ndị ọrịa na ọgwụgwọ, afọ ojuju onye ọrịa na nlekọta, yana obere ihe omume nke iji ọgwụ eme ihe ma ọ bụ ntụgharị.SAMHSA kwubiri na enwere ihe akaebe zuru oke na nhapụ a na-ewusi ike ma na-akwado iji ọrụ OTP na-eche ihu mmụba dị ukwuu na ọnwụ ịdoụbiga mmanya ókè metụtara fentanyl.N'April 2023, SAMHSA melitere ntụzịaka ahụ kpamkpam, na-edegharị ụkpụrụ dabara na ndokwa OTP maka iji methadone na-enweghị nlekọta.
Ntuziaka Eprel 2023 emegharịrị ọhụrụ ga-adị irè ma ọ ga-adị irè otu afọ ka emechara PHE ma ọ bụ ruo mgbe HHS wepụtara iwu ikpeazụ na-emezi 42 CFR Nkebi 8. Ọkwa nke Iwu Nrụpụta na-atụpụta Ndozigharị Nkebi 8 nke 42 CFR (87 FR 77330), akpọrọ "Ọgwụ maka ọgwụgwọ nke nsogbu ojiji Opioid", nke SAMHSA na-arụ ọrụ na-emecha.
Ntuziaka emelitere Eprel 2023 na-ewepụ ihe achọrọ iji were ọgwụ ụlọ na-enweghị nlekọta n'okpuru 42 CFR § 8.12(i) n'okpuru ọnọdụ dị n'okpuru.Karịsịa, TRP nwere ike iji nkwụsị a iji nye methadone n'enweghị nlekọta n'ụlọ dịka oge ọgwụgwọ ọkọlọtọ ndị a si dị:
SAMHSA kwuburu ụzọ na a ga-agbatị mgbanwe a site na Mee 11, 2024. Steeti ga-achọ ịdebanye aha nkwenye ha n'ụzọ doro anya ka ndị OTP steeti jiri ya mee ihe.Steeti ma ọ bụ steeti na-ahụ maka ọgwụgwọ opioid nke enyere ikike ime n'aha steeti nwere ike ịdebanye aha nkwenye ha na nhapụ nke a site na izipu akwụkwọ nkwenye ederede na igbe ozi nke Division of Pharmacological Therapeutics n'oge ọ bụla ka ebipụtachara ntuziaka a.Iji hụ na mgbanwe dị mma na ntụzịaka a sitere na mgbanwe ewepụtara n'oge ihe mberede ahụike ọha na eze COVID-19, a na-agba steeti ume ime ya n'oge na-adịghị anya Mee 10, 2023. Ọ bụrụ na steeti ahụ ejibughị ahapụ March 16, 2020, steeti ka nwere ike ịnye nkwenye ederede.
SAMHSA na-atụkwa aro ime mgbanwe a na-adịgide adịgide dị ka akụkụ nke Ọkwa nke Nhazi Iwu nke Disemba 2022.Ebe ọ bụ na anabatala akwụkwọ ikike ahụ, steeti, OTP na ndị ọzọ metụtara akọpụtala na mgbanwe a amụbawo afọ ojuju ndị ọrịa na ọgwụgwọ yana imeziwanye ntinye aka onye ọrịa.Nkwado maka mgbanwe a abụwo nke ọma nke ukwuu, na akụkọ sitere na ụlọ ọrụ ọgwụgwọ opioid steeti na ndị OTP nke ọ bụla na-atụ aro na nha ahụ na-agba ume ma na-eme ka nlekọta dịkwuo mma ma na-ebelata mkparị metụtara ọrịa opioid ojiji (OUD).
Nchịkwa mmanye ọgwụ ọjọọ (DEA) na ụkpụrụ PHE Dị ka nke Machị 2020, HHS na DEA na-enye ndị ọrụ ohere idepụta oge nhazi oge II-V (“Ihe Ndị Eji Ejikwa”) ihe ndị dabere na nleta telehealth na-enweghị nyocha ahụike mbụ na saịtị.Tụkwasị na nke ahụ, DEA ewepụla ihe a chọrọ ka onye na-arụ ọrụ na-edebanye aha ya na DEA na steeti onye ọrịa ma ọ bụrụ na onye ọrụ ahụ ruru eru ịnye ọgwụ ndị a na-achịkwa site na telemedicine na steeti ebe onye ọrụ ahụ debanyere aha na DEA na United States.Ọkwa onye ọrịa.N'ịchịkọta, a na-akpọ ha "Mgbanwe nke telemedicine na-achịkwa ọgwụ".
Na Maachị 2023, DEA na-achọ nkwupụta na ọkwa mmepe iwu abụọ akwadoro maka mgbanwe mgbanwe ekwentị ọgwụ na-achịkwa.Emebere atụmatụ ndị a iji kwalite ohere ịnweta ọgwụ ndị a na-achịkwa, gụnyere maka ndị batara ọgwụgwọ na mgbanwe mgbanwe.DEA, yana mmekorita ya na SAMHSA, na-ezube iwepụta iwu ikpeazụ site na Nọvemba 11, 2023.
Na nkwubi okwu PHE, DEA na SAMHSA nyere iwu nwa oge na-agbatị mgbanwe telemedicine maka ihe ndị a na-achịkwa ruo na Nọvemba 11, 2023, ebe ha na-atụle mgbanwe na iwu a tụrụ aro dabere na nzaghachi ọha.Na mgbakwunye, ndị ọrụ guzobere mmekọrịta na ndị ọrịa site na telemedicine na ma ọ bụ tupu Nọvemba 11, 2023 nwere ike ịga n'ihu na-enye ndị ọrịa ọgwụ a na-achịkwa n'enweghị nyocha ahụike nke onwe na n'agbanyeghị ma onye ọrụ ahụ nọ na ndebanye aha DEA steeti onye ọrịa tupu ọnwa Nọvemba. .11, 2024.
Ikikere Ahụike Telebehavioral N'oge COVID-19 PHE, ọtụtụ ndị na-ahụ maka ahụike nwere ike ịnye ọrụ telehealth etiti steeti site na nhapụ ikike ikike steeti nyere.Iji bulie ojiji nke telemedicine, steeti nwere ike ikwado inye telemedicine interstate site na ibu ikike ikike.Mbugharị ikike na-ezo aka n'ikike onye ọkachamara ahụike nyere ikike n'otu steeti ịme ọgwụ na steeti ọzọ nwere obere ihe mgbochi na mmachi site na mbufe, nkwenye, ma ọ bụ ịnye ikike.Ịbawanye ikike ịnyefe akwụkwọ ikike na-agbasawanye ịnweta ọrụ nlekọta ahụike ma na-enyere aka kwalite nlekọta ndị ọrịa na-aga n'ihu.
N'ime uru ndị ọzọ, ikike ibu ikike na-enye steeti ohere ijigide ikike nchịkwa, ikwe ka ndị na-ahụ maka ahụike na-ejere ọtụtụ ndị ọrịa ozi, ikwe ka ndị ọrịa nweta nlekọta site na netwọk zuru oke nke ndị na-ahụ maka ahụike, na inyere steeti aka imeziwanye ohere ịnweta obodo nlekọta maka ime obodo na nke dị ala. ọnụọgụ ego..Nkwekọrịta ikikere bụ nkwekọrịta n'etiti steeti ndị na-eme ka usoro ahụ dị mfe ma kwe ka ndị na-enye ọrụ nyefee otu ngwa iji mee na steeti ndị na-esonye.Nkwekọrịta ikikere nwere ike mee ka ibu dị mfe ma belata oge echere maka ndị na-ahụ maka ahụike ka ha na-eme ihe na steeti, na-elekọta nlekọta nchịkwa nke steeti, ma chekwaa ụgwọ ndị na-ahụ maka nlekọta ahụike maka bọọdụ ikikere steeti.Akwụkwọ ikike bara uru maka ma ọrụ nkeonwe yana telemedicine.Nkwekọrịta ikikere dị ugbu a gụnyere: Interstate Treaty on Audiology and Speech Pathology, Counseling Treaty, Emergency Medical Care Treaty, Interstate Medical Licensing Treaty, Nurse Licensing Treaty, Occupational Therapy Treaty, Physical Therapy Treaty, and Inter-Jurisdictional Treaty in Psychology Treaty ọrụ ndị ọzọ.
Nsogbu ahụike omume na ụkọ ndị na-ahụ maka ahụike uche, gụnyere ọgwụgwọ maka nsogbu iji ọgwụ eme ihe, na-arụtụ aka na mkpa ọ dị maka mmụba ikike ikike n'ofe steeti.Enwere ọtụtụ ohere maka steeti iji jiri akụ gọọmentị kwado mgbasawanye nke telemedicine site na inye ikike nke steeti:
HHS jikwaa nkwado ya okpukpu atọ site na HRSA na Federation of State Medical Councils na Association of State and Provincial Psychological Councils, bụ ndị mepụtara Interstate Medical Licensing Treaty, Provider Bridge, Psychological Inter-Jurisdictional Treaty, na Multidisciplinary Licensing Resources, n'otu n'otu, site na ikikere. Nyefee Nyefee.Mmemme.
Na mgbakwunye, akụrụngwa ikike ọhụrụ nwere ozi kachasị ọhụrụ gbasara ikike ikike etiti steeti, nkwekọrịta ikike, na inye ikike maka ndị ọkachamara ahụike omume.Akụrụngwa a na-enye ntụzịaka ọhụụ maka otu esi eme n'ụzọ iwu na ụkpụrụ omume na-abụghị steeti ma na-akwado nnabata nke ụdị ikikere na-agbasawanye ohere nlekọta ahụike.
Ịnweta Broadband Njikọ Ịntanetị Broadband na-ekere òkè dị mkpa n'inyere obodo ndị nwere obere ego aka na ndị mmadụ n'otu n'otu na-eji ọrụ telemedicine.Iji gbasaa ohere brọdband n'ụlọ na steeti, Congress wefere iwu 2021 Consolidated Appropriations Act iji kenye ijeri $3.2 na Federal Communications Commission (FCC) iji mepụta Mmemme Uru Broadband Emergency Broadband (EBB Program) iji nyere ezinụlọ ndị nwere obere ego aka ịkwụ ụgwọ maka ịnweta brọdband na ngwaọrụ netwọk.
Nọvemba 15, 2021 The Infrastructure Investment and Jobs Act (IIJA) na-enye $65 ijeri ego brọdband, nke National Telecommunications and Information Administration (NTIA) nke Ngalaba Azụmahịa ga-ejikwa ya na ụlọ ọrụ Njikọta ọhụrụ emepụtara ọhụrụ. Ịntanetị.ma too.IIJA nyekwara FCC ijeri $14.2 iji kwalite na gbasaa (mmemme EBB) Affordable Connectivity Program (ACP) na ijeri $2 nye USDA iji guzobe ndị otu na-enye brọdband.
Atụmatụ brọdband ndị a ga-enyere aka kwalite ohere ndị ọrịa nwere ọrụ ịntanetị na ngwaọrụ ndị achọrọ maka ọrụ telehealth, na-ebelata ndịiche na ibu ego n'inweta vidiyo na ọrụ ahụike na-enye teknụzụ.