Funding of Telemedicine
Several funding sources are available in Oklahoma for reimbursement of hardware and operations that are the necessary infrastructure to operate telemedicine networks and sites. Further, reimbursement for telemedicine services is available in Oklahoma in the private and public sector.
(See further Title 17 O.S. 139.101 definitions and 139.109 Special OUSF)
- The Oklahoma Telecommunications Act of 1997 established the Oklahoma Universal Service Fund (OUSF). Fees are paid by phone users into a fund that is disbursed primarily to telephone companies. Secondarily, funds are disbursed to several entities, including health care, for purposes of providing telemedicine. The OUSF is administered by the Oklahoma Corporation Commission. (See Title 17 O.S., Section 139.106.)
- The secondary entities that receive OUSF are referred to in statute and rules as “Special Universal Services.” The health care applicant must be a not-for-profit hospital, not-for-profit mental health and substance abuse facility, or federally qualified health center. Also, the OUSF application requires the applicant to have applied for federal funding before state funding. In 2015, telemedicine requests were expected to be approximately $51 million for OUSF for telemedicine infrastructure, as budgeted by the program. In 2016, the OHA, as part of a consortium, worked on overhauling the OUSF from a litigation-based system to an administrative process. The bill, HB 2616, also established deadlines for OCC action once an application for funding is received and established a requirement for competitive bidding of telecommunication carrier services.
- In June 2018, the Federal Communications Commission announced it will boost spending on its telehealth program by $171 million (43 percent) to $571 million, lifting the cap on the program. The program is a Universal Service Fund subsidy for broadband-facilitated diagnosis and treatment. In 2017, $8 million was awarded to Oklahoma entities.
- The Rural Health Care (RHC) Program supports health care facilities in bringing world class medical care to rural areas through increased connectivity. It supports reduced rates for broadband and telecom services. There are two subprograms in the RHC Program: The Healthcare Connect Fund (HCF) program and the Telecommunications (Telecom) program.
- Commercial Insurance, Medicare or Medicaid funding: In Oklahoma, most OHA members are origination or receiving sites for telemedicine. Some Oklahoma hospitals also offer direct-to-consumer visits though an app on a smartphone and are termed virtual care. Reimbursement for telemedicine services can vary depending on the payer. Oklahoma has consumer parity in telemedicine, which means if a service is provided face-to-face and reimbursed, then the telemedicine service must also be reimbursed by the insurance carrier. The Medicaid program in Oklahoma does reimburse for numerous telemedicine services.