Lawmakers To Propose Medicare Telehealth Coverage Bill

July 24, 2014 in News

Reps. Mike Thompson (D-Calif.) and Glenn Thompson (R-Pa.) plan to introduce bipartisan legislation that would incrementally allow Medicare to cover telehealth and remote patient monitoring services, MobiHealthNews reports (Comstock, MobiHealthNews, 7/23).

Background

Earlier this month, CMS in its proposal for the Physician Fee Schedule for calendar year 2015 proposed adding four services to the list of ones that Medicare beneficiaries can receive via telehealth:

  • Annual wellness visits;
  • Psychoanalysis;
  • Psychotherapy; and
  • Prolonged evaluation and management services (iHealthBeat, 7/7).

Bill Details

The bill would amend Title XVIII of the Social Security Act, which limits government-reimbursed telehealth services to rural areas and certain cases, to gradually expand telehealth services covered under Medicare over a four-year period.

After six months, the bill would:

  • Require Medicare to cover telemedicine in urban areas with a population of at least 50,000 people; and
  • Expand the acceptable care sites to include retail clinics.

After two years, the bill would:

  • Allow reimbursement for outpatient services, such as speech therapy and physical therapy, delivered via telehealth;
  • Expand coverage to urban areas with a population between 50,000 and 100,000; Include home telehealth to the list of acceptable care sites; and
  • Require the United States comptroller to conduct a study examining the efficacy and potential savings to Medicare from telehealth.

After four years, the bill would make telehealth reimbursable in all areas, regardless of population size (MobiHealthNews, 7/23).

In addition, the bill would expand Medicare reimbursable services to include remote patient management services for chronic health conditions, such as:

  • Chronic obstructive pulmonary disease;
  • Congestive heart failure; and
  • Diabetes (Bowman, FierceHealthIT, 7/23).

Under the bill, the HHS secretary would be charged with developing and maintaining a set of standards for remote patient monitoring (MobiHealthNews, 7/23).

The bill, which would not expand telehealth services to any other federally run health program, does not include Medicare coverage for telephone audio conversations or emails between patients and providers (FierceHealthIT, 7/23).

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