A new Congressional effort seeks to expand telemedicine by allowing Medicare reimbursement for more treatments – and more people.
The Medicare Telehealth Parity Act of 2014 was introduced in July by U.S. Reps. Mike Thompson (D-CA.) and Gregg Harper (R-MS). If passed into law, the expansion of telehealth services would come in three phases over four years, beginning in counties with populations of less than 50,000 and extending in time to larger counties.
As proposed, the bill would expand the use of Medicare-reimbursed video conferencing and store-and-forward technologies in rural health clinics and health centers. The use of remote patient monitoring for diabetes, congestive heart failure and chronic obstructive pulmonary disease would be included, as well as video conferencing for home health services and agencies, durable medical equipment, home dialysis and hospice services.
In addition, the bill would expand services covered under Medicare to those provided by physical therapists, certified diabetes educators, speech language therapists, audiologists, respiratory therapists and occupational therapists.
[See also: The case against requiring initial face-to-face visits before telemedicine.]
The bill has received support from the American Telemedicine Association and the Telecommunications Industry Association. It has been referred to the House Energy and Commerce Committee and the House Committee on Ways and Means.
"We fully support this effort to improve healthcare access and affordability using telecommunications technology," Jonathan Linkous, the ATA's chief executive officer, said in a press release. "These cost-saving provisions are critical to improve telehealth coverage and extend care to millions of Americans.”
The bill's focus on physical therapy services drew support from the American Physical Therapy Association (APTA), which this year passed a resolution supporting the adoption of telehealth in PT as "an appropriate model of service delivery" when provided in ways that meet association standards and guidelines.
"Although Medicare currently allows some telehealth delivery, the system limits reimbursable use to rural areas, and requires beneficiaries to travel to 'originating sites,' with no provisions for remote patient monitoring," the APTA wrote in an Aug. 1 analysis. "The proposed bill would use a phased-in approach to remove those population-based limits and allow the addition of remote patient monitoring for specific conditions. The bill also requires the General Accountability Office to study the use of remote patient monitoring for outpatient therapy."
The bill's sponsors said this action would put "telehealth services under Medicare on the path toward parity with in-person healthcare visits."
“Telehealth saves money and helps save lives,” Thompson – who's drafted several telemedicine-friendly bills over the past few years, said in a July 31 press release. “By expanding telehealth services, we can make sure the best care and the best treatments are available to all Americans, no matter where they live.”
Calling telehealth "one of the most promising aspects of the healthcare field,” Harper added that in addition to California and Mississippi people all over the country can benefit from an expansion of telehealth services.
This bill is one of several making their way through Congress that seeks to open up telehealth services to more people and healthcare providers, while promising improved reimbursements.
Last year, Thompson and Harper joined several other Congressmen in pushing for the expansion of telehealth services to veterans. The 21st Century Care for Military & Veterans Act (H.R. 3507), submitted on Nov. 15, 2013, seeks to establish and expand reimbursement policies for telehealth coverage under the Veterans' Administration and the Defense Department's TRICARE program.
One month earlier, Thompson and Harper joined U.S. Reps. Peter Welch (D-VT) and Devin Nunes (R-CA) in prosing the Telehealth Enhancement Act (H.R. 3306), which calls for the adoption of payment innovations to improve telehealth coverage. And in September, Nunes joined U.S. Rep. Frank Pallone (D-N.J.) in sponsoring the TELEmedicine for MEDicare (TELE-MED) Act (H.R. 3077), which would enable healthcare providers to treat Medicare patients in other states with telemedicine tools and services but without needing a different license for each state.
Just last month, Republican Sens. Thad Cochrane and Roger Wicker unveiled the Telehealth Enhancement Act, which aims to free doctors to more widely practice medicine via telehealth technologies by altering Medicare payment policies to cover some critical access hospitals and home health services. Cochran and Wicker are calling their bill a "companion bill" to the 2013 bill submitted by Thompson, Harper, Welch and Nunes.
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