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mHealth Reimbursement

MGMA, AMIA Weigh In on CMS’ RPM, Digital Health Reimbursement Plans

September 10, 2018 - The Centers for Medicare & Medicaid Services may be taking a step forward with proposed improved reimbursements for remote patient monitoring and other digital health services, but some worry that those changes will negatively affect provider workflows to a point that no one will be interested in going after the money. In comments to CMS regarding the agency’s proposed 2019...


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Telemedicine Gives SNFs a Tool to Improve Care, Cut Medicare Costs

by Eric Wicklund

An after-hours telemedicine platform helped a Brooklyn-based skilled nursing facility eliminate almost 100 hospitalizations and save roughly $1.5 million in Medicare costs in one year. Those outcomes are included in a case study published...

CMS Overhaul of ACO Rules Includes a Nod to Telehealth’s Value

by Eric Wicklund

A federal effort to revamp the rules around Accountable Care Organizations includes a few nods to telehealth and telemedicine, giving healthcare providers hope that connected care platforms will become more prominent in an overhauled...

Groups Sue Anthem Over Telehealth-Friendly ER Review Policy

by Eric Wicklund

A national payer’s policy of screening ER visits to promote telehealth and mHealth options is being challenged in court. The American College of Emergency Physicians (ACEP) and Medical Association of Georgia (MAG) have...

CMS Makes a ‘Landmark Change’ in RPM, Telehealth Reimbursement

by Eric Wicklund

Earlier this month, the Centers for Medicare & Medicaid Services unveiled its proposed 2019 Medicare Physician Fee Schedule and Quality Payment Program, with several amendments designed to boost remote patient monitoring and telehealth...

CMS Proposes More Medicare Reimbursement For Telehealth, RPM

by Eric Wicklund

The federal government is once again moving toward acceptance of telehealth and remote patient monitoring with new rules on how Medicare reimburses providers for their use of connected health technology. The Centers for Medicare &...

Are State Medicaid Programs Doing Enough to Support Telemedicine?

by Eric Wicklund

Roughly 40 percent of the nation’s Medicaid programs are taking a progressive approach to telehealth and telemedicine reimbursement, according to a new analysis. At the same time, about 20 percent of state programs are classified as...

CMS Embraces mHealth With Reimbursement for Smartphone CGM Links

by Eric Wicklund

Healthcare providers who collaborate with diabetic patients through smartphone-enabled continuous glucose monitors (CGMs) will soon be reimbursed under Medicare. The Centers for Medicare & Medicaid Services announced the change in...

OIG: HIV Telemedicine Program Doesn’t Violate Anti-Kickback Laws

by Eric Wicklund

A healthcare provider offering free telemedicine equipment to a county health clinic for use in HIV treatment and support services won’t be sanctioned under federal anti-kickback laws, according to the Health and Human Services...

mHealth, Telehealth Groups Lobby CMS for Better RPM Reimbursement

by Eric Wicklund

Close to 50 healthcare organizations and vendors are lobbying the Centers for Medicare & Medicaid Services to improve reimbursement opportunities for remote patient monitoring. In a letter delivered this morning to CMS Administrator...

Will a Payer’s New ER Policy Give Telehealth a Boost in Texas?

by Eric Wicklund

A move by Texas’ largest health insurer to reduce unnecessary ER visits could provide a welcome boost to direct-to-consumer telehealth programs in the state. Beginning in June, Blue Cross and Blue Shield of Texas will begin...

State Medicaid Programs Are Seeing the Value of Telehealth at Home

by Eric Wicklund

State lawmakers are coming around to the concept of allowing Medicaid members to access telehealth and telemedicine services from their own homes. In its spring 2018 update of the State Telehealth Laws and Reimbursement Policies Report,...

Feds Take CMS to Task Over Improper Telehealth Reimbursements

by Eric Wicklund

About three of every 10 Medicare reimbursements for telehealth in 2014-15 were made in error, according to a recent audit by federal regulators. The U.S. Health and Human Services Department of the Inspector General announced last week...

Utah Lawmakers, Payers Grapple Over Telemental Health Legislation

by Eric Wicklund

Utah lawmakers are grappling with proposed legislation that would require insurers to cover telemental health consults. HB 139, sponsored by Rep. Steve Eliason (R.-Sandy), would mandate that the state’s Medicaid program and private...

OIG Expands Telehealth, Telemedicine Audits to Medicaid Claims

by Eric Wicklund

Healthcare providers will be checking to make sure their telehealth and telemedicine programs comply with state Medicaid regulations following news that the Health and Human Services Department’s Office of the Inspector General will...

Telemedicine Success Often Hinges on Aligning Providers and Payers

by Eric Wicklund

Sometimes a telemedicine service can offer too much value to let a little thing like reimbursement stand in the way. For a group of seven community health centers in Massachusetts, that service is teledermatology. Faced with an...

MA Telehealth Bill Set For Passage; Others Aren’t So Fortunate

by Eric Wicklund

A proposed bill to boost telehealth coverage in Medicare Advantage plans is set for passage, while other bills that would loosen Medicare’s restrictions on telemedicine and telehealth – including expanding telestroke services...

CCHP’s State Telehealth Report Shows Gradual Advances in Coverage

by Eric Wicklund

Nearly every state provides Medicaid reimbursement for video-based telehealth, according to the latest report from the Center for Connected Health Policy. In addition, 15 states cover store-and-forward or asynchronous services, and 21...

CMS, AMA Look for Common Ground on Remote Patient Monitoring

by Eric Wicklund

Fans of remote patient monitoring found a lot to like in new payment rules released last week by the Centers for Medicare & Medicaid Services, continuing what many hope is a trend toward CMS support for mHealth and telehealth...

CMS Won’t Cover Telehealth in Medicare Diabetes Prevention Program

by Eric Wicklund

The Centers for Medicare and Medicaid Services has once again declined to cover virtual coaching platforms in the Medicare Diabetes Prevention Program, saying the mHealth and telehealth platform isn’t reliable enough to warrant...

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