Hundreds of thousands of Medicare recipients to lose telehealth services

March 29, 2013 in Medical Technology

Hundreds of thousands of Medicare beneficiaries in almost 100 counties across the United States and its territories will be losing coverage for telehealth services because they no longer live in federally designated rural areas.

As a result of the 2010 Census, 97 counties in 36 states and territories are being redefined as metropolitan, rather than rural, Standard Metropolitan Statistical Areas (SMSAs), according to officials with the American Telemedicine Association. That change in status revokes the option for Medicare recipients in those counties to use video conferencing services for healthcare.

ATA officials say Medicare doesn’t cover telemedicine in metropolitan areas, where more than 80 percent of all Medicare recipients live.

[See also: Telemedicine for all.]

The news isn’t entirely bad, though. The new SMSA rules also change 28 counties from metropolitan to non-metropolitan, thus making Medicare residents in those counties eligible for telehealth services.

The changes were discussed during the ATA’s monthly “This Month in Telemedicine” videocast earlier this week, then outlined in a press release issued on March 27.

”When it comes to telemedicine, Congress has long overlooked the need for telemedicine services to residents of urban counties, despite the fact that they often suffer similar problems accessing healthcare. Now, because of a statistical quirk, even more people will lose coverage of these services, reducing access and care,” said Jonathan Linkous, the ATA’s CEO, in the press release. “Medicare should cover remote health services for all beneficiaries, regardless of location. We call on Congress to ensure that existing beneficiaries will not lose coverage for these services.”

During the videocast, Linkous and Gary Capistrant, the ATA’s senior director of public policy, said the ATA will petition federal officials to enable Medicare recipients in the newly-changed counties to continue to qualify for telehealth services.

[See also: Telemedicine bills in state hoppers.]

‘We’re going to need a lot of support,” said Linkous, who added that that ATA believes those counties should be grandfathered.

Among the hardest hit states, Linkous and Capistrant said, is Delaware, whose three counties – New Castle, Kent and Sussex – are now all classified as urban counties. Other states heavily affected by the SMSA changes are Virginia, North Carolina and Texas.

According to the ATA, the following counties are slated to lose telehealth coverage for Medicare beneficiaries:

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