Group Urges Expansion of Medicare Coverage of Telehealth

October 20, 2014 in News

A group of the largest pharmacies and health care organizations in the U.S. is pressing federal lawmakers to broaden the types of telehealth services that are covered by government insurance programs, the Washington Post‘s “Capital Business” reports (Ho, “Capital Business,” Washington Post, 10/19).

Background

Earlier this year, telehealth proponents sent letters to HHS Secretary Sylvia Mathews Burwell, arguing that Medicare reimbursement rules are hindering telehealth adoption.

For example, the Alliance for Connected Care in a letter noted that Medicare reimburses for telehealth services only in limited circumstances. The group added that such barriers run “counter to the Medicare Shared Savings Program’s goal of ACOs having the ability to coordinate care using telehealth, remote patient monitoring and other such enabling technologies.”

Meanwhile, a coalition of telehealth organizations in a separate letter to Burwell wrote that 80% of Medicare beneficiaries do not meet the agency’s current restrictive definitions (iHealthBeat, 6/9).

According to “Capital Business,” current laws restrict Medicare coverage for telehealth services to rural hospitals and health centers.

Group Continues Calls for Coverage Expansion

The Alliance for Connected Care continues to argue that current federal laws limit the number of U.S. residents who are able to access telehealth services.

Krista Drobac, a health care lobbyist representing the coalition, said Congress passed the restrictions on telehealth coverage in 1999, when such services were largely seen as needed only by those in rural areas who could not easily access care. However, she noted that telehealth services have changed to include initiatives such as retail health clinics, which are not covered under Medicare.

Specifically, the group is pressing lawmakers to allow telehealth services to be substituted for in-person care under Medicare. In addition, the group is pushing CMS to waive current Medicare restrictions on telehealth services that apply to ACOs.

Drobac said, “We want telemedicine to be part of the continuum of care of Medicare patients.”

Reps. Gregg Harper (R-Miss.) and Mike Thompson (D-Calif.) in July co-sponsored legislation, called the Medicare Telehealth Parity Act of 2014 (HR 5380), which would change Medicare coverage to include retail health clinics (“Capital Business,” Washington Post, 10/19).

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