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HEART Act Targets Medicare Limits on Rural Telehealth, RPM

The bill - the latest to take aim at Medicare's restrictions on telemedicine - seeks to boost rural residents' access to telehealth and bolster remote patient monitoring programs for those with heart disease.

Source: ThinkStock

By Eric Wicklund

- A new bill making its way around Capitol Hill aims to improve access to telehealth services for people with heart disease and those in rural parts of the country.

The Helping Expand Access to Rural Telehealth (HEART) Act, filed on May 3 by U.S. Rep. Sean Duffy (R-Wis.), aims to improve access to telehealth in rural parts of the country and expand remote patient monitoring programs for people with chronic obstructive pulmonary disease (COPD) and congestive heart failure.

Duffy, chairman of the House Financial Services Subcommittee on Housing and Insurance, is targeting a familiar deterrent to telemedicine: The Centers for Medicare & Medicaid Services, which sets strict limits on reimbursement in rural areas that curb the development of new RPM platforms.

“People in rural areas across America have been left behind, and they deserve access to modern medical practices,” he said in a press release. “The HEART Act will help Americans improve healthcare quality and contact with healthcare professionals, regardless of where they live.”

Duffy’s bill joins a growing list of proposed legislation seeking to reduce barriers to telemedicine, often by amending Medicare regulations. In fact, the bill was introduced at the same time as – and overshadowed by – the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017, introduced last week by six senators and endorsed by more than 50 healthcare providers and organizations.

In pleading his case, Duffy points out that telehealth programs for people with chronic conditions saved Medicare some $670 million between 2006 and 2009 and resulted in 20,500 less hospitalizations, when compared to traditional post-acute care models. And in 2012, the average telehealth program cost $1,600 per patient per year, compared to $13,000 for home health service care and more than $70,000 for nursing home care.

Against that backdrop, Duffy said virtual visits are expected to grow from almost 20 million in 2014 to more than 158 million by 2020. A lot of that growth will affect Medicare beneficiaries, who saw a 28 percent increase in telemedicine visits from 2004 to 2013. And of the 107,000 telemedicine visits recorded in 2013, more than 40,000 occurred in rural areas.

Duffy joins a long line of telehealth advocates lobbying CMS to relax its restrictions on telemedicine. The chief complaint is that Medicare reimburses providers for telemedicine only in rural areas, but its definition of a rural area eliminates large parts of the country where such services are needed. In addition, Medicare limits originating sites, or locations where telemedicine can be delivered, and has steered clear of asynchronous or store-and-forward telemedicine save for pilot projects in Alaska and Hawaii.

Last December, the American Heart Association called on CMS to support telehealth for treating stroke patients and those with heart disease, saying the technology has been “tragically underutilized” can could save the country billions of dollars and thousands of lives.

“With heart disease and stroke being leading causes of death in our nation, our healthcare system must continue to adapt to take full advantage of proven forms of treatment, like telehealth, that can effectively fight these deadly diseases and advance health care quality,” AHA CEO Nancy Brown said in a press release. “Barriers must be removed so that more Americans suffering from CVD and stroke, regardless of where they live, can reap the benefits of this valuable type of care.”

Also last year, Pennsylvania-based Capital Blue Cross released the results of a year-long remote patient monitoring study on patients with heart disease in which the health plan reportedly saved $8,000 per patient and reduced hospitalizations by more than 30 percent.

The HEART Act and CONNECT for Health Act join a growing list of telemedicine-friendly legislation on Capitol Hill, including the CHRONIC Care Act of 2017, the Hallways to Health Act, the Furthering Access to Stroke Telemedicine (FAST) Act the Telehealth Innovation and Improvement Act.

Telehealth and telemedicine also figured prominently in the massive 21st Century Cures Act, the Expanding Capacity for Health Outcomes (ECHO) Act and the National Defense Authorization Act, all passed by Congress and signed into law.

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