News Feature | May 4, 2015

Telehealth Reimbursement Gets New Focus Via The Senate

By Megan Williams, contributing writer

Telehealth Reimbursement Gets New Focus Via The Senate

If the issue of reimbursement for telehealth solutions has been a hurdle for your healthcare IT clients, be aware that the situation is steadily changing.

The Backstory
Last year, the Medicare Telehealth Parity Act Of 2014 was introduced, and opened the doorto allowing Medicare to cover telemedicine services. (Read up on coverage of the bill in relation to IT solutions providers here.) The bill essentially allowed for four services to be eligible for Medicare reimbursement if delivered via telehealth channels:

  • prolonged evaluation and management
  • psychoanalysis
  • psychotherapy
  • annual wellness visits

Senate Action
According to Healthcare Informatics, the Senate Committee On Commerce, Science, and Transportation’s Subcommittee on Communications, Technology, Innovation, and the Internet held a hearing on April 21 in which they examined ways telehealth could be used to cut costs and improve patient outcomes. Topics discussed included:

  • the FCC’s shortage of promotion for telehealth
  • interstate licensing (and the lack thereof)
  • broadband connectivity issues
  • limitations to provider reimbursement

Overall, the subcommittee members agreed on the need to increase the use of telehealth, with many looking to Medicare for reimbursement.

Of course there are concerns around an increased use of telehealth technology. Senator Edward Markey (D-MA) expressed concerns about privacy issues in terms of PHI (protected health information) and additionally the potential need for Congress to pass legislation around security requirements for telehealth providers.

Subcommittee Chairman Roger Wicker (R-MS) also announced his plans with Senator Thad Cochran (R-MS) to reintroduce a bill that would extend coverage for telehealth services to underserved areas in the form of the “Telehealth Advancement Act.” The bill would authorize ACOs (accountable care organizations) that are covered by Medicare Advantage plans reimbursement for providing remote patient monitoring and telehealth services.

The Hearing
According to HIMSS, Senators Wicker and Cochran are looking to introduce the act later this Congress, a move that’s been endorsed by the American Telehealth Association (ATA).

Jonathan D. Linkous, CEO of the ATA issued two recommendations. First, the approval of two small legislative changes to the Telecommunications Act in relation to rural health care providers and discounted broadband rates (the current list is almost 20 years old) and additionally the inclusion of ambulance and emergency transport providers, clinics in elementary, secondary, and post-secondary school, and other sites where telehealth services are provided for Medicare or Medicaid patients.

Secondly he recommended that provider access to advanced telecommunications and information services be considered on a need-basis rather than geographic, in a model similar to schools and libraries.

Going Deeper
Read up on the results of a cost-benefit study on telehealth in acute care settings here