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mHealth Reimbursement

OIG Expands Telehealth, Telemedicine Audits to Medicaid Claims

November 21, 2017 - 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 be launching an audit. The OIG made the announcement this week that it would be reviewing state Medicaid payments for telemedicine and other remote services...


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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 average wait...

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 states...

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 technology....

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 reimbursement....

Kansas Payers Push Back Against Telehealth Payment Parity

by Eric Wicklund

Payers in Kansas are fighting proposals for payment parity in telehealth, saying a virtual visit shouldn’t be reimbursed at the same rate as in in-person visit. “Telemedicine services are not equivalent to in-person services and,...

Telehealth Bills Get Senate Approval, Good News From CBO

by Eric Wicklund

A bill to boost telehealth coverage in Medicare Advantage plans would reduce healthcare expenditures by $80 million over the next decade, according to the Congressional Budget Office. The CBO’s cost estimate of H.R. 3727 is welcome news...

More Organizations Urge CMS to Boost Medicare Telehealth Coverage

by Eric Wicklund

Healthcare organizations and advocacy groups are ganging up on the Centers for Medicare & Medicaid Services in a bid to compel more telehealth and telemedicine coverage. The Healthcare Information and Management Systems Society (HIMSS), American...

Congress Mulls Proposal to Boost Telehealth Coverage in MA Plans

by Eric Wicklund

The latest telehealth bill surfacing in Washington DC targets Medicare Advantage plans. H.R. 3727, introduced on Sept. 11 by US Reps. Diane Black (R-Tenn.), Mike Thompson (D-Calif.), Doris Matsui (D-Calif..) and Susan Brooks (R-Ind.), would enable...

AMGA Lobbies CMS to Give Telehealth More Medicare Opportunities

by Eric Wicklund

The American Medical Group Association is lobbying for more Medicare acceptance of telehealth, by recommending five new CPT codes and a demonstration of the value of virtual coaching platform for those with diabetes. In a letter issued on Sept....

Medicare Spending on Telehealth Increases, But Barriers Remain

by Eric Wicklund

Healthcare providers may be using more telehealth and telemedicine than ever before, but Medicare Is still a significant barrier to growth. An analysis of the Centers for Medicare and Medicare Services’ 2016 payments for telehealth and...

New Bill Seeks to Expand Medicare Reimbursement for Telemedicine

by Eric Wicklund

A bill to expand Medicare coverage for telehealth services that has been kicked around on Capitol Hill since 2013 is once again in Congress’ hands. U.S. Rep. Gregg Harper (R-Miss.) has re-introduced the Telehealth Enhancement Act (H.R....

Feds to Probe Improper Telehealth Reimbursements Under Medicare

by Eric Wicklund

Federal officials are investigating whether physicians are receiving improper reimbursements for telehealth under Medicare Part B guidelines. The Health and Human Services Department’s Office of the Inspector General (OIG) will be checking...

mHealth Companies Fined for Medicare Fraud on Wearable Monitors

by Eric Wicklund

Federal officials say the developers of an mHealth wearable forced doctors to bill Medicare for remote patient monitoring services that were more expensive than necessary. The U.S. Department of Justice has levied a $13.45 million fine against...

Providers Must Negotiate Telehealth Reimbursement With Payers

by Eric Wicklund

Healthcare providers looking to launch a new telemedicine or mHealth program may find an unexpected ally in commercial health plans. While only 31 states and the District of Colombia mandate that private payers cover telehealth visits as they...

Bill Seeks Medicare Reimbursement for New Telehealth Programs

by Eric Wicklund

Congress will revisit a bill that seeks to expand telehealth across the nation by improving Medicare reimbursements. Sens. Cory Gardner (R-Colo.) and Gary Peters (D-Mich.) have re-introduced the Telehealth Innovation and Improvement Act, after...

WEDI Brief Outlines Challenges to Telehealth Reimbursement

by Eric Wicklund

Healthcare providers face many challenges in launching and sustaining a telehealth program – including finding the right CPT codes, if they exist, for reimbursement. In many cases, a telehealth or telemedicine procedure is so new, a proper...

CMS Urged to Reimburse Telehealth for Stroke, Cardiac Care

by Eric Wicklund

The American Heart Association is calling on Medicare to support telehealth, saying the technology is “tragically underutilized” to treat stroke patients and those with heart disease and could save the country billions of dollars...

Payers urge CBO to Give Telemedicine a Fair Shake

by Eric Wicklund

Nearly a dozen national health plans have asked the Congressional Budget Office to pay more attention to telemedicine when scoring Congressional bills on Medicare. In a letter to CBO Director Keith Hall, 11 health plans say telemedicine programs...

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