LITTLE ROCK, Ark. -- Telehealth visits have jumped nationwide since the onset of the pandemic. Between mid-March and mid-June, an estimated 9 million Medicare recipients relied on Telemedicine.

Data show among private insurers, telehealth visit claims increased by more than 4,000%. But now providers are pulling back from covering non-COVID-related virtual visits, and costs for patients are increasingly muddled. Some could even end up with surprise medical bills.

Tom Conroy, CEO of the health care technology company MedSign, explained why.

"They do not have safeguards. There's no safeguards in the system where they can actually tell if a Telehealth session occurred officially," Conroy said. "Last year in Florida there was fraudulent charges for Telehealth to the order of $1.2 billion. And the reason is, there's no controls in the system."

But denying access to Telehealth coverage could have major repercussions for rural states such as Arkansas, where transportation continues to be a barrier for patients seeking care, and where hospitals and providers have relied on Telehealth payments to stay afloat during the pandemic.

Conroy added in the long run, covering Telehealth visits could save the government Medicare dollars by encouraging preventive care.

"Seniors use 75% - 80% of all Medicare dollars," he said. "One of the reasons why is they go into the hospital, the minute they step over the emergency room doorway, it's $3,000. If they stay inside of hospital either in New York or in California, in Los Angeles, it's $17,000 a day. Extraordinary costs."

The American Medical Association and several lawmakers have voiced support for legislation that would increase access to telemedicine from all types of providers, as well as ensure Medicare coverage for virtual visits.



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As winter looms in Missouri, health officials are expressing concern over the potential for three viruses to impact facilities.

This season has already seen an early spike in flu cases - and widespread impact among children from Respiratory Syncytial Virus, or RSV.

The potential for another COVID spike to add to this situation has some medical experts worried about a so-called 'tripledemic,' straining the health-care system.

Recent memory features the COVID surge in early 2020 filling up hospitals, but Dave Dillon - spokesperson for the Missouri Hospital Association - said while there are some similarities to that time there is one important difference.

"Unlike where we were in the beginning portion of 2020 where hospitals didn't have tools, but they had a lot of staff and a lot of space, right now we are limited on staff," said Dillon. "A lot of individuals have left the profession, especially front-line care givers like nurses."

Data analysis of the nursing workforce shows that the total supply of Registered Nurses in the U.S. decreased by 100,000 in 2021, the largest drop ever recorded.

Dillon said this flu season is showing early intensity, being both very contagious and requiring a much higher degree of hospitalization than normally seen at this stage of the season.

He said that while RSV is impacting capacity at children's hospitals, it's not anticipated to impact adult bed availability.

"Unless the influence of the other viruses creates a significant shortage of hospital bed availability," said Dillon, "RSV is not likely to have a significant negative influence upon adult bed capacity for seniors who are more likely to be hit hard by RSV. "

Experts advocate keeping up to date on vaccinations for COVID and flu.

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Correction: The strain Northeast Nebraska Public Health Department is seeing most right now is H3N1, rather than H3N2.

CORRECTION: The flu strain the Northeast Nebraska Public Health Department is seeing most frequently is H3N1, not H3N2. (9:00 a.m. MDT, Dec. 5, 2022)


Nebraska is one of a dozen states experiencing "very high" levels of influenza, and the highest percentage of cases has been in children and young adults.

Children under 17 account for more than half the Nebraska flu cases so far, with the highest numbers in the five- to 17-year-old age group, and second-highest in children birth to four years of age.

Molly Herman, epidemiology coordinator for the Northeast Nebraska Public Health Department in Wayne, where they have among the highest percentages in the state, said the strain they are seeing the most is H3N1.

"That is usually a strain that causes more severe illness in people, more hospitalizations and more deaths," Herman pointed out. "It's really important to get vaccinated, because any flu vaccine is going to give you a level of protection that's going to help keep you from getting super sick."

The Centers for Disease Control and Prevention recommends flu shots for anyone over six months of age, and parents with questions should check with their child's doctor. And for preventing illnesses of all kinds, it's important to wash your hands regularly, cover coughs and sneezes and be willing to stay home when you're not feeling well.

There have been two flu-related deaths in Nebraska so far, and four reported outbreaks in long-term care facilities.

Douglas County has the highest percentage of flu cases in the state, and the highest number of flu-related hospitalizations by this point in over a decade. In November, the county reported 2,300 cases, compared to 26 last November.

Herman noted RSV infection is also high in her region, although statewide, RSV cases peaked in early November and have slowly declined since then. She added COVID numbers have varied, and the state's wastewater monitoring has been very helpful in predicting what they might see.

"And what we've found is that whenever the concentration of virus goes up in wastewater, about 10 to 14 days later, we will see a rise in cases locally," Herman explained. "We saw a huge spike in wastewater about November first, and then, sure enough, 10 to 14 days later is when we started our increase in cases."

The state's mid-November wastewater surveillance revealed COVID to be "high to very high" in 12 of 14 sites monitored. With flu, RSV and COVID circulating, health experts say there's a risk of co-infection, with two or even three viruses at the same time.


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Results of a new survey show many young people are worried about losing access to birth control.

The survey, by the nonprofit Power to Decide, found about seven in 10 young adults think the U.S. Supreme Court's decision to overturn Roe v. Wade, which protected the right to an abortion, will also limit access to birth control.

Federal lawmakers have stepped in to try to codify rights to birth control, with the Right to Contraception Act, which passed in the House but is stalled in the Senate.

Tara Mancini, director of public policy at Power to Decide, noted there are actions which could be taken at the state level.

"We've seen some states work to amend constitutions to give folks the right to abortion," Mancini observed. "Michigan was even more broad, recognizing the right to, not just abortion, but sexual and reproductive health care."

In 2019, New York approved the Comprehensive Contraception Act, which provides insurance coverage for Food and Drug Administration-approved contraceptive drugs, devices and products. Mancini added providing more funding to Title 10 programs could help, so clinics and communities can offer family planning and STI testing services.

She pointed out it would also reduce the number of "contraception deserts," including in parts of New York.

Power to Decide is hoping more people bring issues about abortion and contraception to light, so they won't seem rare. Mancini noted there is still a stigma associated with birth control, including the myth of one method being best for everyone. Her group works to ensure people have access to a wide range of birth control options.

"Every person is different, everybody is different, and so what works for me might not work for my neighbor," Mancini asserted. "That's why it's essential that folks have access to the full range of birth control methods, of which there are over 18 FDA-approved method categories."

She added another myth is birth control is easy to get. Despite myths and stigmas, Mancini feels hopeful for the future of birth control, since the survey found it is not a controversial topic overall, and is accepted across ethnicities and the political divide.

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