Medicare Advantage

New bipartisan bill touts Medicare reimbursements for telehealth

For more information on Medicare, please call the number below to speak with a healthcare specialist


New bipartisan bill touts Medicare reimbursements for telehealth

A growing movement in the nation’s healthcare system is the use and implementation of telehealth. As defined by the Health Resources Services Administration (HRSA), telehealth involves using electronic information and telecommunications technologies to deliver health-related services and information. Basically, telehealth enables two-way, real-time, interactive communication between patients and healthcare providers based in distant locations.

With constant, new technologies, telehealth would seem to be a natural. However, various bills have been proposed – and failed – to remove existing provisions restricting Medicare reimbursements. The Congressional Budget Office (CBO), which provides budget and economic information, feels that telehealth services could lead to higher healthcare spending. But if passed, a new bipartisan bill would be the first step to expanding reimbursements. In fact, long-term Medicare savings totaling $1.8 billion are predicted.

Long-distance medical lifelines

Among its benefits, telehealth is used to deliver and support remote clinical healthcare, public health, patient and professional education and training and health administration. This healthcare platform is vital in rural areas and remote locations without sufficient health care services, such as those affected by natural disasters.

Telehealth employs a wide array of technologies, including: basic audio (radio) and video, telephones, Internet, videoconferencing, store-and-forward imaging, streaming media and wireless communication. And, it can involve remote patient monitoring devices, which collect and transmit patient data for monitoring and interpretation.

Under the Social Security Act (SSA), telehealth services are covered and reimbursed by Medicaid, the social program for low-incomes individuals and families. “Telehealth is the future of health care,” stated Senator Brian Schatz (D-Hawaii), the main sponsor. “It saves money and improves health outcomes. Our bipartisan bill puts us on a path to transform health care delivery, making it less costly and more convenient for patients and providers.”

Removing restrictions in place

But since 2005, various SSA provisions have prevented Medicare from reimbursing telehealth services. For instance, some restrict telehealth use rural areas, while others only permit the use of specific technology outside of Alaska and Hawaii. The current bipartisan bill (S. 2484), introduced on Feb. 2, 2016, is better known as The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act. If passed, it would waive Medicare’s requirement that telehealth services occur at a qualified site for participating providers.

Providers would have to submit annual reports to the Department of Health and Human Services (HHS) showing their telehealth-related financial costs. These would be evidence of telehealth technologies’ reductions for Medicare spending. In fact, the lawmakers claim that over the next 10 years, the bill will save the federal government $1.8 billion. It’s true that telehealth services can increase some costs by expanding preventive services access. But they can also decrease long-term costs for patients who only receive medical care after becoming very sick.

The bill’s expected to be widely supported in Congress. And, more than 50 industry organizations have endorsed it, including: AARP, the American Medical Association and the Healthcare Information and Management Systems Society. Rep. Gregg Harper (R-Miss.), another sponsor, said that if the bill passes, it wouldn’t affect other pending legislation concerned with telehealth’s role in Medicare. Harper also helped introduced the Medicare Telehealth Parity Act of 2015, which would reimburse doctors for offering telehealth services outside of rural areas. It would also allow new types of specialists to be reimbursed for telehealth visits.

If passed, the CONNECT for Health Act may become part of the Senate Finance Committee’s Chronic Care Working Group. This focuses on improving Medicare’s treatment of beneficiaries with multiple chronic conditions. It provides high-quality home healthcare and improves access to interdisciplinary, team-based care, including telehealth.