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Lawmakers Want Medicare Changed to Expand Telehealth Services

A Congressional Telehealth Caucus is supporting legislation that would greatly expand the reach and scope of telehealth and telemedicine services covered by Medicare.

Source: ThinkStock

By Eric Wicklund

- Legislators are ramping up their efforts to expand Medicare coverage for telehealth and telemedicine.

The latest bill to take the spotlight is the Medicare Telehealth Parity Act of 2017 (HR 2550), re-introduced in May by a familiar group of pro-telehealth lawmakers and designed to gradually expand both the scope and reach of telemedicine services allowed by Medicare.

The bill failed during its first introduction in 2015, but is now getting support from the Congressional Telehealth Caucus, a bipartisan group of lawmakers whose ranks have reportedly grown in recent weeks.  Advocates say the bill – one of several making the rounds on Capitol Hill – could make it through Congress because it addresses familiar pain points in telehealth and offers an incremental plan for expansion.

An analysis by the law firm of Foley & Lardner explains the bill’s three phases:

  1. The first phase would expand qualifying originating sites to include all federally qualified health centers (FQHCs) and all rural health clinics, and expand qualifying geographic locations to include counties in Metropolitan Statistical Areas of fewer than 50,000 residents. It would also expand telehealth coverage to include services offered by certified diabetes educators, respiratory therapists, audiologists, occupational therapists, speech language therapists and physical therapists. Finally, it would compel Medicare to cover asynchronous (store-and-forward) telehealth services across the country, not just in Alaska and Hawaii.
  2. The second phase would add the home to the list of qualifying originating sites, and expand qualifying geographic locations to include counties in Metropolitan Statistical Areas with populations of between 50,000 and 100,000.
  3. The third phase would add counties in Metropolitan Statistical Areas with populations above 100,000 to the list of qualifying geographic locations. It would also authorize the Centers for Medicare & Medicaid Services (CMS) to develop and implement new payment methods for telehealth services.

The bill also calls for Medicare coverage of remote patient monitoring (RPM) services for covered chronic care conditions and home dialysis for patients with end-stage renal disease.

READ MORE: Telehealth Growth, Savings Tied to Parity Laws

“The introduction of the Medicare Telehealth Parity Act of 2017, coupled with other telehealth-related bills and the creation of the Congressional Telehealth Caucus, represents continued progress towards expanded telehealth coverage and hopefully portends increasing support for and understanding of telehealth benefits among federal lawmakers,” Foley & Lardner attorneys Nathaniel M. Lacktman and Thomas B. Ferrante said in their analysis. “Healthcare providers and telemedicine companies should recognize the importance of this progress, as it is an opportunity to contribute their voices and help shape public policy on telehealth and virtual care services.”

The bill was introduced by Rep. Mike Thompson (D-Calif.) and has five Republican and eight Democratic co-sponsors, as of July 12. It’s currently before the House Subcommittee on Health.

The Congressional Telehealth Caucus was launched in May by Thompson, alongside Reps. Gregg Harper (R-Miss.), Diane Black (R-Tenn.) and Peter Welch (D-Vt.).

“Telehealth saves lives and reduces costs; it’s a win-win for both patients and providers,” Thompson said in a joint press release announcing the caucus and its support of both the Medicare Telehealth Parity Act and the CONNECT for Health Act. “The caucus will give us a venue to collaborate with our interested colleagues to advance the delivery of care via telemedicine.”

Several other telehealth-themed bills are making their way through Congress, including:

  • The Telehealth Innovation and Improvement Act, which seeks to encourage more healthcare providers to launch telehealth programs through the Department of Health and Human Services’ Center for Medicare and Medicaid Innovation (CMI) and calls on the CMI to evaluate telehealth models “for cost, effectiveness and improvement in quality of care without increasing the cost of delivery” and to reimburse them under Medicare if they meet those criteria.
  • The Helping Expand Access to Rural Telehealth (HEART) Act, which 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.
  • The Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017, which targets Medicare payment reform by improving chronic disease management services and care coordination at home.
  • The Chronic Kidney Disease Improvement in Research and Treatment Act of 2017, which seeks to make digital health a key component of treatment for chronic kidney disease treatment. 
  • The Furthering Access to Stroke Telemedicine (FAST) Act, which would alter the Social Security Act to allow Medicare coverage of telestroke services no matter where the patient is located (current legislation allows those services only in certain rural areas).
  • The Hallways to Health Act, which aims to boost telehealth services in schools by connecting them with community health centers and providing more avenues for reimbursement, and would create a demonstration project to expand telehealth access in schools and in medically underserved areas.
  • And the Veterans E-Health & Telemedicine Support (VETS) Act of 2017, which would ease restrictions on telehealth and mHealth for veterans, especially those in rural areas. But that bill may be faltering: Politico reports that the bill wasn’t part of the Senate Veterans Affairs Committee’s July 11 hearing on several pieces of healthcare legislation, and is still facing opposition from the American Medical Association.

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