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.

  • 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 (OCC). (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 2016, the OHA, as part of a consortium, worked on overhauling the OUSF from a litigation-based system to an administrative process. House Bill 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.
  • The Federal Communications Commission program is a Universal Service Fund subsidy for broadband-facilitated diagnosis and treatment. In 2020, the FCC announced the Commission would carry forward up to $197.98 million in unused funds to provide $802.7 million to meet growing demand for telehealth in rural America. In several COVID relief packages, Congress appropriated an additional $449.95 million to the COVID-19 Telehealth Program at the FCC. The FCC COVID-19 Telehealth program supports the efforts of health care providers to continue serving their patients by providing reimbursement for telecommunications services, information services and connected devices necessary to enable telehealth during the pandemic. It is unknown if these programs will continue after the end of the public health emergency in 2023.
  • The federal 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.
  • On Nov. 10, 2022, the FCC released a Notice of Funding Opportunity (NOFO) for the Affordable Connectivity Program (ACP) Outreach Grant Program. The ACP is a $14.2 billion FCC program that helps ensure that qualifying low-income households can afford the broadband they need for work, school, health care and more.
  • 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, termed virtual care. Reimbursement for telemedicine services can vary depending on the payer. The Medicaid program in Oklahoma does reimburse for numerous telemedicine services.

      (See further Title 17 O.S. 139.101 definitions and 139.109 Special OUSF)