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Urubuga rwizewe .gov rukoresha HTTPS (padlock) cyangwa https: // guhagarika bivuze ko uhujwe nurubuga rwa .gov muburyo butekanye.Sangira amakuru yoroheje kurubuga rwemewe, rufite umutekano.
Murakaza neza kuri HHS.gov yongeye gushushanya ishyirwa mubikorwa rya sisitemu yo muri Amerika.Ibirimo no kugendana bikomeza kuba bimwe, ariko igishushanyo cyavuguruwe kirashoboka cyane kandi cyoroshye-kigendanwa.
Mu gihe Ishami ry’Ubuzima na Serivisi zita ku bantu (HHS cyangwa Ishami) rikomeje inzira yo kuva muri politiki yihutirwa ya COVID-19, Ishami rirashaka gusobanura ejo hazaza h’ubuzima bwa telehealth n’uburyo bwo kugenzura kure kugira ngo abarwayi bakomeze guhabwa no kubona ubufasha bahawe bikenewe.Hano hepfo ni urupapuro rwerekana ibizahinduka ku barwayi n’abatanga ubuvuzi igihe umunyamabanga wa HHS atangaje ko byihutirwa by’ubuzima rusange (PHE) kuri COVID-19 hashingiwe ku ngingo ya 319 y’itegeko ryita ku buzima rusange (reba hano hepfo)), ritazahinduka. nka “COVID”.-19 PHE ”).PHE irangira.Kongere yemeje itegeko rya Omnibus Appropriations ryo mu 2023, ryagura byinshi muri gahunda yubuzima telehealth ihindagurika abantu baje kwishingikiriza mugihe cya PHE COVID-19 kugeza mu mpera za 2024. HHS kugirango basangire ubundi buyobozi bwamakuru agezweho nigihe ntarengwa kijyanye no gukomeza ibyo byoroshye Muri hiyongereyeho, Ubuyobozi bushinzwe umutungo na serivisi (HRSA) bukoresha urubuga rwa HHS www.Telehealth.HHS.gov, ruzakomeza kuba isoko y’abarwayi, abatanga ubuvuzi ndetse na leta ku makuru y’itumanaho nk’imikorere myiza ya telemedine, ivugurura rya politiki no gusubizwa, impushya za leta, kubona umurongo mugari, amahirwe yo gutera inkunga, nibikorwa.
Medicare na Telehealth Mugihe cya PHE, abantu bafite Medicare bafite amahirwe menshi yo kubona serivisi za telehealth, harimo no mu ngo zabo, muri rusange nta mbogamizi zikoreshwa mu turere cyangwa aho ziherereye bitewe n’itegeko ry’umwanditsi w’imitungo itanga inyongera ku itegeko riteganya no gusubiza kuri Telemedisine 2020 na Coronavirus.Imfashanyo, ubutabazi n’amategeko y’umutekano mu bukungu.Telemedicine ikubiyemo serivisi zitangwa binyuze muri sisitemu y'itumanaho nka mudasobwa kandi ikemerera abashinzwe ubuzima kwita ku barwayi kure aho kuba ku biro byabo.Itegeko ryo guhuriza hamwe amafaranga yo mu 2023 ryagura imiti myinshi ya Medicare telemedicine kugeza ku ya 31 Ukuboza 2024, nka:
Byongeye kandi, nyuma yitariki ya 31 Ukuboza 2024, igihe ibyo guhinduka birangiye, ACOs zimwe zishobora gutanga serivisi za telehealth, zemerera abaganga bitabiriye ACO n’abandi bavuzi kwita ku barwayi batiriwe basura imbonankubone, batitaye aho baba.Niba utanga ubuvuzi yitabira ACO, abantu bagomba kugenzura nabo kugirango bamenye serivisi za telehealth zishobora kuboneka.Gahunda yo Kwivuza Medicare igomba kuba ikubiyemo serivisi za terefegitura ya Medicare kandi irashobora gutanga serivisi zinyongera za telehealth.Abantu biyandikishije muri gahunda ya Medicare Advantage plan bagomba kugenzura ubwishingizi bwa telehealth hamwe na gahunda yabo.
Ibihugu bifite Medicaid, CHIP, na Telehealth bifite ihinduka ryinshi mu gukwirakwiza Medicaid na serivisi z’ubwishingizi bw’ubuzima bw’abana (CHIP) zitangwa binyuze kuri telehealth.Kubera iyo mpamvu, imiterere ya telemedisine iratandukanye bitewe na leta, zimwe zifitanye isano n’irangira rya COVID-19 PHE, zimwe zifitanye isano n’itangazwa rya leta rya PHE n’ibindi byihutirwa, ndetse zimwe zitangwa na gahunda ya leta ya Medicaid na CHIP mbere y’icyorezo.Nyuma yo guhagarika gahunda ya PHE ihuriweho, amategeko ya Medicaid na CHIP telehealth azakomeza gutandukana na leta.Ibigo bishinzwe ubuvuzi na Medicaid (CMS) bishishikariza ibihugu gukomeza kwishyura serivisi za Medicaid na CHIP zitangwa binyuze kuri telehealth.Mu rwego rwo gufasha ibihugu gukomeza, kwemeza, cyangwa kwagura politiki yo gukwirakwiza no kwishura kuri telehealth, CMS yasohoye ibikoresho bya Leta Medicaid na CHIP Telehealth Toolkit, hamwe n’inyandiko y'inyongera igaragaza ingingo za politiki ibihugu bigomba gukemura kugira ngo biteze imbere uburyo rusange bwa telehealth: https: // www.medicaid.gov / medicaid / inyungu / gukuramo / medicaid-chip-telehealth-toolkit.pdf;
Ubwishingizi bw'ubuzima bwigenga na Telemedisine Nkuko bisanzwe bigenda mugihe cya PHE COVID-19, PHE COVID-19 imaze kurangira, ubwishingizi bwa telemedisine hamwe nizindi serivisi zita kure bizatandukana na gahunda yubwishingizi bwigenga.Ku bijyanye na telemedisine hamwe nizindi serivisi zita kure, ibigo byubwishingizi byigenga birashobora gusaba kugabana ibiciro, kubanza kubiherwa uruhushya, cyangwa ubundi buryo bwo gucunga ubuvuzi bwa serivisi.Kubindi bisobanuro bijyanye nuburyo umwishingizi yifashisha kuri telemedisine, abarwayi bagomba guhamagara nimero ya serivisi y’abakiriya babo iri inyuma yikarita yabo yubwishingizi.
Mugihe cya PHE COVID-19, kunshuro yambere, abatanga ubuvuzi bagengwa n’amategeko agenga ubuzima bwite bwa HIPAA, Umutekano, no Kutubahiriza Amategeko (Itegeko rya HIPAA) barashaka kuvugana n’abarwayi no gutanga serivisi za telehealth bakoresheje ikoranabuhanga ry’itumanaho rya kure rishobora. ntarasobanuka neza.Icyifuzo cya HIPAA.Ibiro bya HHS bishinzwe uburenganzira bw’abaturage (OCR) byatangaje ko guhera ku ya 17 Werurwe 2020, bizakoresha ubushishozi kandi ko bitazatanga amande ku bashinzwe ubuzima batubahiriza amategeko ya HIPAA.Abatanga ibikoresho bakoresheje ikoranabuhanga iryo ari ryo ryose rya kure barashobora kubikoresha nta kibazo cya OCR bahanwa kubera kutubahiriza amategeko ya HIPAA.Ubu bushishozi bukoreshwa kuri serivisi za telemedisine zitangwa kubwimpamvu iyo ari yo yose, niba serivisi za telemedisine zifitanye isano no gusuzuma no kuvura indwara zubuvuzi zijyanye na COVID-19.
Ku ya 11 Mata 2023, OCR yatangaje ko kubera ko PHE COVID-19 irangiye, iri tangazo ryubahirizwa rizarangira ku ya 11 Gicurasi 2023 saa 11:59.OCR izakomeza gushyigikira ikoreshwa rya telemedicine nyuma ya PHE iha abashinzwe ubuzima batwikiriye igihe cyiminsi 90 yinzibacyuho kugirango bahindure ibikenewe byose mubikorwa byabo kugirango batange imiti muburyo bwibanga kandi bwizewe nkuko bisabwa namabwiriza yubuvuzi ya HIPAA .Muri iki gihe cyinzibacyuho, OCR izakomeza gushyira mu bikorwa ubushishozi bwayo kandi ntizahana ibihano by’ubuvuzi bitwikiriye kubera kutubahiriza amategeko agenga imikorere ya HIPAA Telemedicine.Igihe cyinzibacyuho kizatangira ku ya 12 Gicurasi 2023 kirangire ku ya 9 Kanama 2023 saa 23:59.
Kubindi bisobanuro, nyamuneka sura urubuga rwa OCR kugirango umenyeshe igihe kirangirire kumatangazo amwe n'amwe yatanzwe kubera ikibazo cyihutirwa cya COVID-19.
Ubuzima bwa Telebehavioral muri Gahunda yo Kuvura Opioid Kuva aho PHE itangiriye, Ikigo cya HHS gishinzwe gufata nabi imiti n’ubuzima bwo mu mutwe (SAMHSA) cyasohoye amabwiriza agenga imikorere ya gahunda nyinshi zo kuvura opiyide (OTP) kugira ngo zifashe gukemura ingaruka z’ubuzima bw’imibereho itandukanye muri OTP n’abarwayi bayo ..
Ikizamini cy’ubuvuzi ku giti cyawe: SAMHSA yanze icyifuzo cya OTP kugira ngo isuzumwe ku buvuzi ku murwayi uwo ari we wese uzahabwa OTP buprenorphine, hashingiwe ko umuganga wa porogaramu, umuganga w’ibanze, cyangwa inzobere mu by'ubuzima zemewe zikurikiranwa na gahunda yo gufata ibyemezo kwa Muganga.Isuzuma rihagije ryimiterere yumurwayi rirashobora gukorwa hakoreshejwe telemedisine.SAMHSA yatangaje ko iyi mikorere izongerwa kugeza ku ya 11 Gicurasi 2024. Iyongerwa rizatangira gukurikizwa ku ya 11 Gicurasi 2023, kandi SAMHSA irasaba kandi ko iyi mikorere ihoraho mu rwego rwo Kumenyesha ko hashyizweho amategeko, azashyirwa ahagaragara mu Kuboza. 2022.
Dose yo murugo: Muri Werurwe 2020, SAMHSA yatanze icyemezo cyo kureka OTP, aho leta zishobora gusaba "ubusonerwe rusange kubarwayi bose bahagaze neza muri OTP kwakira iminsi igera kuri 28 ya dosiye ya opioide.Imiti yo gukoresha ibiyobyabwenge Koresha imvururu.Ibihugu birashobora kandi "gusaba iminsi igera kuri 14 imiti yo murugo kubarwayi badahagaze neza ariko OTP igena ko ishobora gukemura neza urwego rwimiti yo murugo."
Mu myaka itatu kuva iki cyemezo cyatanzwe, leta, OTP, hamwe n’abandi bafatanyabikorwa batangaje ko byatumye abantu barushaho kwishora mu buvuzi, kongera abarwayi banyurwa no kwitabwaho, ndetse bikaba ari bike ugereranyije n’ibiyobyabwenge cyangwa ibiyobyabwenge.SAMHSA yashoje avuga ko hari ibimenyetso bihagije byerekana ko uku gusonerwa gushimangira kandi gushishikariza ikoreshwa rya serivisi za OTP mu gihe ubwiyongere bukabije bw’impfu ziterwa na fentanyl.Muri Mata 2023, SAMHSA yavuguruye rwose ubuyobozi, ivugurura ibipimo bikurikizwa ku ngingo za OTP zo gukoresha methadone idakurikiranwa.
Ubu buyobozi bushya bwavuguruwe muri Mata 2023 buzatangira gukurikizwa nyuma y’irangira rya PHE kandi bizakomeza gukurikizwa umwaka umwe nyuma y’irangira rya PHE cyangwa kugeza igihe HHS itanze itegeko rya nyuma rihindura 42 CFR Igice cya 8. Itangazo ry’itegeko ryashyizweho risaba ko hahindurwa Igice cya 8 cya 42 CFR (87 FR 77330), cyiswe “Imiti yo kuvura indwara ziterwa na Opioid”, SAMHSA ikora mu kurangiza.
Ubuyobozi bwavuguruwe muri Mata 2023 busonera icyifuzo cyo gufata imiti yo murugo utagenzuwe na 42 CFR § 8.12 (i) mubihe bikurikira.By'umwihariko, TRP irashobora gukoresha uku kureka kugirango itange urugero rwa methadone idakurikiranwa murugo ukurikije ibihe bisanzwe byo kuvura:
SAMHSA yabanje gutangaza ko ubwo bworoherane buzongerwa kugeza ku ya 11 Gicurasi 2024. Ibihugu bizakenera kwiyemeza kwemeza ko byemewe kuri ubwo busonerwe kugira ngo Leta ya OTP ibikoreshe.Ibihugu cyangwa ibigo byita ku barwayi ba opioid bemerewe gukora mu izina rya leta birashobora kwandikisha uburenganzira bwabo kuri ubwo busonerwe mu kohereza urupapuro rwabigenewe rwanditse mu ishami ry’iposita y’imiti y’imiti igihe icyo ari cyo cyose nyuma y’itangazwa ry’aya mabwiriza.Kugirango habeho impinduka nziza kuri ubu buyobozi biturutse ku bworoherane bwashyizwe ahagaragara mu gihe cyihutirwa cy’ubuzima rusange bwa COVID-19, ibihugu birashishikarizwa kubikora bitarenze ku ya 10 Gicurasi 2023. Niba Leta itarakoresheje mbere yo gusonerwa ku ya 16 Werurwe 2020, leta irashobora gutanga uruhushya rwanditse.
SAMHSA irasaba kandi ko ibyo byahinduka burundu mu rwego rwo kumenyekanisha Ukuboza 2022.Kuva iki cyemezo cyatangwa, leta, OTP hamwe n’abandi bafatanyabikorwa batangaje ko ubwo buryo bworoshye bwongereye abarwayi kunyurwa no kuvurwa no kurushaho kunoza imikoranire y’abarwayi.Inkunga kuri ubu buryo bworoshye yabaye nziza cyane, hamwe na raporo z’inzego za Leta zita ku barwayi ba opioid na OTP ku giti cyabo zerekana ko iki cyemezo gishishikariza kandi kigateza imbere ubuvuzi mu gihe hagabanywa agasuzuguro kajyanye no gukoresha indwara ya opioide (OUD).
Ubuyobozi bushinzwe kurwanya ibiyobyabwenge (DEA) n’amabwiriza ya PHE Kuva muri Werurwe 2020, HHS na DEA bemerera abimenyereza kwandika gahunda ya II-V (“Ibintu bigenzurwa”) igenzurwa hashingiwe ku gusura telehealth nta kwisuzumisha kwa mbere kwa muganga.Byongeye kandi, DEA yakuyeho icyifuzo cy’uko umuganga yandikwa muri DEA muri leta y’umurwayi niba uwimenyereza yemerewe kwandika imiti igenzurwa hakoreshejwe telemedisine muri leta aho uyimenyereye yanditswe muri DEA no muri Amerika.Imiterere y'abarwayi.Hamwe na hamwe, bavugwa nka "Imiti igenzurwa na Telemedicine Flexibility".
Muri Werurwe 2023, DEA irashaka ibisobanuro ku matangazo abiri yatanzwe yo guteza imbere amategeko agenga ibiyobyabwenge byanduye.Ibi byifuzo bigamije guteza imbere uburyo bwo kubona imiti igenzurwa, harimo kubantu binjiye kwivuza byoroshye.DEA, ku bufatanye na SAMHSA, irateganya gutanga itegeko rya nyuma bitarenze ku ya 11 Ugushyingo 2023.
Umwanzuro wa PHE, DEA na SAMHSA basohoye itegeko ry’agateganyo ryagura imiti igabanya imiti igenzurwa kugeza ku ya 11 Ugushyingo 2023, mu gihe harebwa impinduka ku itegeko ryashyizweho hashingiwe ku bitekerezo rusange.Byongeye kandi, abakora imyitozo bagiranye umubano n’abarwayi bakoresheje telemedisine ku ya 11 Ugushyingo 2023 cyangwa mbere yayo, barashobora gukomeza guha imiti abarwayi bagenzuwe batabanje kwisuzumisha kwa muganga kandi batitaye ko niba uyimenyereza ari kuri leta y’umurwayi DEA mbere y’Ugushyingo. .11, 2024.
Uruhushya rwubuzima bwa Telebehavioral Mugihe cya COVID-19 PHE, abatanga ubuvuzi benshi barashobora gutanga serivise za terefegitura zinyuranye binyuze muburenganzira bwatanzwe na leta.Kugirango urusheho gukoresha ikoreshwa rya telemedisine, leta zirashobora koroshya itangwa rya telemedicine ihuza ibihugu binyuze muburenganzira.Uruhushya rwo gutwara ibicuruzwa bivuga ubushobozi bwinzobere mu buvuzi zemewe muri leta imwe yo gukora ubuvuzi mu kindi gihugu gifite imbogamizi ntoya kandi zibujijwe binyuze mu kwimura, kwemeza, cyangwa gutanga uruhushya.Kongera ubushobozi bwo kwimura impushya byagura serivisi zita kubuzima kandi bigafasha kunoza uburyo bwo kwita ku barwayi.
Mu zindi nyungu, uruhushya rushobora kwemerera ibihugu kugumana imbaraga z’ubuyobozi, kwemerera abatanga ubuvuzi guha abarwayi benshi, kwemerera abarwayi kwitabwaho n’urusobe runini rw’abatanga ubuvuzi, no gufasha ibihugu kunoza uburyo bwo kugera ku baturage bita ku cyaro n’abato- abaturage binjiza..Amasezerano yimpushya ni amasezerano hagati yigihugu cyoroshya inzira kandi cyemerera abatanga serivise gutanga icyifuzo kimwe cyo kwitoza mubihugu byitabiriye.Amasezerano yimpushya arashobora koroshya umutwaro no kugabanya igihe cyo gutegereza abashinzwe ubuzima bakora imyitozo hanze yigihugu, gukomeza kugenzura leta, no kuzigama amafaranga yubuvuzi kubuyobozi bwa leta.Impushya zo gutanga uruhushya ni ingirakamaro kuri serivisi bwite na telemedisine.Amasezerano yimpushya zihari zirimo: Amasezerano y’ibihugu kuri Audioologiya na Speech Pathology, Amasezerano y’ubujyanama, Amasezerano y’ubuvuzi bwihutirwa, Amasezerano yo gutanga impushya z’ubuvuzi, amasezerano y’impushya z’abaforomo, amasezerano y’ubuvuzi bw’akazi, amasezerano y’ubuvuzi bw’umubiri, hamwe n’amasezerano ya psychologiya hagati y’ububasha. indi myuga.
Ikibazo cy’ubuzima bw’imyitwarire hamwe n’ibura ry’abatanga ubuvuzi bwo mu mutwe, harimo no kuvura indwara ziterwa n’ibiyobyabwenge, byerekana ko hakenewe ingufu z’impushya mu bihugu byose.Hariho amahirwe menshi kugirango leta zikoreshe umutungo wa federasiyo kugirango zunganire kwagura telemedisine binyuze muburenganzira bwa leta:
HHS yikubye inshuro eshatu inkunga binyuze muri HRSA muri Federasiyo y’Inama y’Ubuvuzi ya Leta n’ishyirahamwe ry’Inama Njyanama z’Intara n’Intara, zashyizeho amasezerano yo gutanga impushya z’ubuvuzi hagati y’ibihugu, Ikiraro gitanga isoko, Amasezerano mpuzamahanga y’ububasha, hamwe n’umutungo utanga impushya nyinshi, binyuze mu ruhushya. Kohereza inkunga.Gahunda.
Byongeye kandi, ibikoresho bishya byimpushya bikubiyemo amakuru agezweho kubyerekeye impushya za leta, amasezerano yimpushya, hamwe nimpushya zinzobere mubuzima bwimyitwarire.Aya masoko atanga ubuyobozi bugezweho bwuburyo bwo gukurikiza amategeko n’imyitwarire hanze y’igihugu kandi bushishikarizwa kwemeza uburyo bw’impushya bwagura uburyo bwo kwivuza.
Umuyoboro mugari Umuyoboro mugari wa interineti ufite uruhare runini mu gufasha abaturage binjiza amafaranga make n'abantu ku giti cyabo gukoresha serivisi za telemedisine.Mu rwego rwo kwagura umurongo mugari mu ngo no muri Leta, Kongere yemeje itegeko ryo kwishyiriraho amafaranga 2021 kugira ngo rigabanye miliyari 3.2 z'amadolari muri komisiyo ishinzwe itumanaho (FCC) kugira ngo hashyizweho gahunda y’inyungu zihutirwa (EBB Program) kugira ngo ifashe ingo zifite amikoro make kwishyura umurongo mugari kandi ibikoresho by'urusobe.
Ku ya 15 Ugushyingo 2021 Itegeko rigenga ishoramari n’ibikorwa remezo (IIJA) ritanga miliyari 65 z’amadolari y’inkunga yagutse, muri yo miliyari 48.2 z’amadolari azacungwa n’ikigo cy’igihugu gishinzwe itumanaho n’itumanaho (NTIA) cy’ishami ry’ubucuruzi mu kigo gishya gishinzwe guhuza ibikorwa na Internet.kandi ukure.IIJA kandi yahaye FCC miliyari 14.2 z'amadolari yo kuzamura no kwagura (gahunda ya EBB) Porogaramu ishinzwe guhuza ibikorwa (ACP) na miliyari 2 z'amadolari muri USDA yo gushinga amakoperative yo gutanga umurongo mugari.
Iyi gahunda ya Broadband izafasha guteza imbere abarwayi kugera kuri serivisi za interineti n’ibikoresho bikenerwa muri serivisi za telehealth, kugabanya itandukaniro n’imitwaro y’amafaranga mu kugera kuri serivisi zikoresha amashusho n’ubuzima.