Telehealth groups to Burwell: Ease these 5 burdens

No sooner did Sylvia Matthews Burwell take over as Health and Human Services Secretary than a collection of telemedicine and mHealth associations asked her to eliminate some of the roadblocks to ubiquity.

The groups did so by touting the potential $36 billion that could be saved with remote monitoring and rattling off benefits such as better care, reduced hospitalizations and readmissions, complication avoidance and improved satisfaction among chronically ill patients.

Standing in the way of that promise, they argued, are policies and payment models that make it harder for healthcare providers to collect reimbursement for services via telehealth tools.

Specifically, the American Telemedicine Association called on Burwell to ease these five restrictions:

1. No coverage for about 80 percent of Medicare beneficiaries who happen to live in the 1,200 metropolitan counties not included in the definition of “rural”.

2. No coverage for “store-and-forward” services (such as transmission of medical images) for the 43 million beneficiaries who live outside of Alaska and Hawaii.

3. No coverage for services originating from a beneficiary’s home (even for the “homebound), a hospice and other common non-medical locations from which a beneficiary seeks service.

4. No coverage for otherwise covered Medicare services of physical therapy, occupational therapy, speech-language pathology, audiology and some other practitioners.

5. No coverage for most health procedure codes, precluding the best judgment of physicians and other practitioners about the medical needs and other circumstances of all Medicare beneficiaries.

“We are writing to encourage you to use your existing authority to waive the current restrictions in the Social Security Act for telemedicine and remote patient monitoring services in the Medicare Shared Savings Program,” the ATA wrote in its letter. “In addition, we urge for you to request comment on the use of telemedicine and remote monitoring solutions by Accountable Care Organizations in the forthcoming Notice of Proposed Rulemaking for the MSSP.”

The ATA’s letter, co-signed by the Healthcare Information and Management Systems Society (the parent company of mHealth News), the Telecommunications Industry Association and technology vendors Intel, Panasonic and Qualcomm, among several others, was not the only one sent addressing ACOs and MSSP.

The Alliance for Connected Care penned its own letter.

“We strongly urge you to … waive the restrictions on the coverage and reimbursement of telehealth services for ACOs to enable the success of these new models of care deliver,” the alliance explained in its letter, which lists nearly 30 members, including WellPoint, Verizon, Teladoc, CVS, Walgreens and a number of industry associations. “At the very least, we request that you include a request for comment on this issue in the upcoming NPRM to ensure that beneficiaries and the ACO community can comment on the importance of telehealth.”

There’s no guaranteeing that Burwell will grant that request, but asking for a public comments period to address telehealth under a program as substantial for both industry and the government as it is for ACOs and MSSP seems like a reasonable first step.

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