Legislator Introduces New Bill to Remove Medicare Telehealth Barriers
March 21, 2016, 10:45 am
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telestrokeSenator Roger Wicker, R-Mississippi has introduced legislation that seeks to remove barriers to telehealth services in Medicare. Medicare fee for service (FFS) does currently provide reimbursement for telehealth services to patients at rural area health clinics, however, current law limits telehealth reimbursement to rural areas, disallows the storage of information to physicians via electronic medical records, email and other communications technology and doesn’t reimburse telehealth services provided by physical or occupational therapists or for physicians who treat patients within their own home.
The bill, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, attempts to broaden telehealth services across the country and offer an added opportunity to serve the needs of the elderly. The bill, which has broad bipartisan congressional support, would allow Medicare patients to use video conferencing, remote patient monitoring and technology to transfer patient data and will expand Medicare reimbursement of telehealth consultations and remote patient monitoring with fewer restrictions.
“This legislation has the potential to remove barriers to new healthcare delivery models that promote coordinated and patient-centered care. Importantly, the bill aims to maintain high standards whether a patient is seeing a physician in an office or via telemedicine,” said American Medical Association (AMA) President Steven Stack. “Telemedicine can strengthen the patient-physician relationship and improve access for patients with chronic conditions and limited access to quality care. The AMA’s guiding principles on telemedicine seek to foster innovation while promoting quality care.”
According to an analysis by the health-care consulting firm Avalere, expanded Telehealth services could save $1.8 billion dollars in medical cost over the next ten years by removing the current restrictions, and would make healthcare more available for patients who often struggle with access to the latest high quality care.
“We strongly believe in the importance of implementing processes and procedures for telemedicine. Our experience working with regional hospitals as well as enterprise level healthcare systems, has demonstrated that effectively executed telemedicine programs can drive significant value,” comments Dr. James Kiely, Partner, ACT. “In our most recent peer-reviewed article, we’ve proven that a telemedicine system can produce meaningful improvement in markers of telestroke efficiency in the face of rapid growth of a telestroke network.”
With a vastly aging population, Federal and State legislators must continue to make improvements in access to quality healthcare for Medicare patients even if it means establishing new legislation designed to govern telemedicine responsibly.
States are Leading the Way on Telemedicine Expansion
July 25, 2013, 10:55 am
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telemedicineThe states of Missouri and Kentucky are the two most recent states that are making significant strides in increased implementation and utilization of telemedicine. Effective Jan. 1, 2014, a Missouri law (House Bill 986) makes private insurers responsible for reimbursing providers offering telehealth services just as these payers are for in-person services. The bill states that insurers “shall not deny coverage for a health care service on the basis that the health care service is provided through telehealth if the same service would be covered if provided through face-to-face diagnosis, consultation, or treatment.” While the new legislation benefits patients with private insurance payers, Missouri law still lacks provision for Medicaid beneficiaries.
In Kentucky, where state laws are in place for private and public payers, the legislators have expanded coverage of telemedicine services for Medicaid beneficiaries so long as these are delivered exclusively by way of interactive video-conferencing. The telehealth services covered by the law are extensive, ranging from mental health evaluations and care management to diabetes and physical therapy consultations.
These most recent events are indicative of individual state legislatures making the most aggressive progress towards removing regulations and passing legislation to accommodate the new technology’s use, while the federal government continues to focus on achieving a last place finish in the race for expansion.
American Telemedicine Association (ATA) CEO Jonathan Linkous said in a public statement recently. “The federal government places unnecessarily strict barriers and restraints on how Medicare patients are served when they deserve access to quality healthcare, regardless of geographic location and technology used.”
Kentucky and Missouri are joining a growing list of states that are realizing the benefit of telemedicine as a cost-effective delivery model for quality healthcare even though the two states have taken different approaches to expand access to telemedicine services. “This is a true win-win scenario,” said Jonathan Linkous, “First, it is a big victory for patients in Kentucky and Missouri, who now have greater access to the best-possible healthcare. It’s also a win for the treasury and taxpayers in those states, who will save significantly on public healthcare costs.”
With healthcare costs rising rapidly and access to specialized care diminishing for many Americans, it is well past a reasonable period of time for the top payer of medical services, the federal healthcare agencies and the U.S. Congress, to pick up the pace on making advances in passing and implementing legislation that will promote the advancement of telemedicine throughout the entire country.
Not Yet Out of the Woods
January 8, 2013, 10:55 am
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statisticsAs most Americans celebrated the New Year, our elected representatives met in Washington to approve legislation narrowly avoiding the ‘fiscal cliff.’ As part of its extensive provisions, the new legislation saved Medicare providers from an impending 2% payment reduction that would have gone into effect on January 1 and postponed spending cuts to Medicare, but only for two months. Within the terms of the agreement, negotiations on ways to cut spending are expected to resume after this period, meaning hospitals are still facing the risk of cuts triggered by uncertainty and further harm if the reduction does eventually takes effect.
While overall Medicare spending may not be affected now, hospitals are still face a long-term decrease in payments. The compromise legislation includes the “doc fix,” which negates a 26.5% decrease in Medicare payments to physicians, with hospitals bearing the brunt of financing it. The tally will come to about $15 billion over 10 years, or roughly half the total cost of the one-year fix. On top of those made by the passage of major healthcare reform in 2010, the new cuts include decreases in payout from both projected Medicare payment increases for inpatient or overnight stays and Medicaid disproportionate share payments, as well as reducing risk-adjusted payments to Medicare Advantage plans.
The kind of last-minute action taken by Congress is a reminder of the severe need to address the provider payment formula for Medicare reimbursement with a long-term solution. Short-term fixes ultimately result in a reduction of important healthcare services detrimental to both patient and provider. Until a solution is reached, hospitals simply cannot afford to cover the difference.
Building Better Policy
August 21, 2012, 5:11 pm
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vermontOver the past several years, studies such as those conducted by the CDC and the National Institute of Health have constantly shown great disparity in levels of healthcare access across America. Particularly for poorer and rural areas, a lack of proper access has historically been extremely costly both in terms of human life and a greater economic impact. Policy makers, government officials, and leaders of health care organizations have recognized this divide, and are focused on identifying and eliminating barriers to patient access to provide a better, more uniform standard of effective healthcare across the country.
Thanks largely to leaps in technology and growing infrastructure, telemedicine is emerging as a highly effective solution with the potential to shape the future landscape of healthcare in America. The innovative, modern solutions offered by the growing telemedicine field combat the logistical challenges of the current state of healthcare, while having been proven to be more cost effective. Now, legislators are finally beginning to see the light.
On a state level, governments that have passed new telehealth legislation have seen positive results across the board. Powerful new applications and techniques have helped simplify and streamline remote patient consultation and monitoring, delivering better care with less economic impact with patient satisfaction rates nearing 100%. A dozen states, including Georgia, are leading the way on acknowledging telemedicine as an effective and efficient solution. So far in 2012, Maryland and Vermont have become the latest states to require private insurance companies to pay for telemedicine services.
The adoption of telemedicine marks a revolution in healthcare that carries great possibility for lasting impact. Creating a legislative environment in which telemedicine can flourish must continue to become a priority in a nation interested in reducing costs and saving lives.
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