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A letter signed by 14 Democratic Senators charges the FCC and Chairman Ajit Pai with failing to properly manage the Rural Health Care Program and the COVID-19 Telehealth Program, thus hindering attempts to expand telehealth access in rural America.

A group of lawmakers is taking the Federal Communications Commission and Chairman Ajit Pai to task for what they say is the mismanagement of programs aimed at expanding telehealth opportunities in rural America.

In an August 20 letter signed by 14 Senators, all Democrats, Pai and the FCC are charged with dragging their feet on both the Rural Health Care Program and the COVID-19 Telehealth Program, the latter of which was created in March to fund telehealth projects tackling access issued caused by the coronavirus.

“Specifically, the Commission has not made sufficient funding available, has delayed rural health care funding decisions, and has not been transparent about its operations,” the letter states. “We urge you to address these issues as soon as possible.”

The lawmakers noted that the RHC Program, launched in 1996, was amended in 2018 to provide more money for project aimed at increasing broadband connectivity for telehealth and other programs in rural parts of the country.

“While on the one hand this is positive, on the other hand, these rollover funds were only available because the extreme delays in processing applications from the previous year were so significant that applicants did not have a chance to spend the funding that was ultimately committed to them,” the letter charges. “These processing delays continue today; a significant number of applicants for FY 2019 funding have still not received word whether or not their applications have been approved, even though many of these applications were filed over 13 months ago and the application filing window for the next funding year, FY 2020, just recently closed.”

The Senators also charge Pai and the FCC with failing to provide guidance to the Universal Service Administrative Company (USAC) on how to handle the backlog of funding applications and how to prioritize funding when demand outstrips support.

“The coronavirus pandemic has continued to exacerbate increasing demands on the RHC Program,” the letter continues. “The waiver of Medicare restrictions to encourage telehealth visits, coupled with states’ stay-at-home orders, have required many health care providers to increase their broadband capacity to enable greater use of telehealth. Although the use of telehealth has increased dramatically during the pandemic, a widely cited barrier is broadband availability. Cash-strapped health care providers are looking to the RHC Program for help to defray these costs, but you have so far not taken steps that would allow health care providers to receive additional support through the program for broadband connectivity.”

With the COVID-19 Telehealth Program, created through the CARES Act, the Senators have charged Pai and the FCC with failing to provide requested information on the program, including how many applications for funding were received, how many were approved, how applications were ranked or denied, and whether providers have received their money.

The charges aren’t new. Lawmakers on at least two occasions have asked Pai and the agency to release that information, at the same time that they’ve sought to add more funding so that the program can be continued.

According to the FCC, the $200 million program approved 539 funding applications from 47 states, Washington DC and Guam before running out of funding in July. Pai has said the agency will conduct a full review of the program.

“The steps we have taken thus far have been very well received, not least by the recipient health care institutions and the communities they serve,” he said in a June 22 letter to lawmakers. “But we also want to assess after the Program’s conclusion how COVID-19 Telehealth Program funding was spent and lessons that could improve the Commission’s upcoming Connected Care Pilot Program. Participants are expected to report to the Commission on the effectiveness of this funding on health outcomes, patient treatment, health care facility administration, and any other relevant factors.”

In their latest letter, the lawmakers are asking Pai and the FCC to address five issues by September 3:

  1. Why aren’t the FCC and USAC working together to solve the backlog of applications for RHC Program funding?
  2. Why did the FCC create a new program – the $100 million Connected Care Pilot Program – while the RHC Program was having funding difficulties?
  3. How has the FCC amended the RHC Program to give healthcare providers more support for broadband connectivity, and what else can the agency do to support more programs, particularly during the pandemic?
  4. Why hasn’t the FCC boosted subsidies for RHC Program participants during the FY 2019 funding year and beyond to address increased demand? And
  5. Why isn’t the FCC providing requested information on the COVID-19 Telehealth Program?

The letter is signed by Senators Brian Schatz (D-HI), Maria Cantwell (D-WA), Tammy Duckworth (D-IL), Tom Udall (D-NM), Tammy Baldwin (D-WI), Richard Blumenthal (D-CT), Ron Wyden (D-OR), Jeffrey Merkley (D-OR), Dianne Feinstein (D-CA), Edward Markey (D-MA), Amy Klobuchar (D-MN), Gary Peters (D-MI), Chris Van Hollen (D-MD) and Maggie Hassan (D-NH).

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