Latest telemedicine bill would expand Medicare reimbursement beyond rural communities

Originally posted on MedCity News by 


Two telemedicine bills introduced in the Senate and re-introduced in the House this week hope to expand the telemedicine services reimbursement by Medicare, as well as extend them to urban areas. Reimbursement tends to focus on rural populations.

U.S. Reps. Mike Thompson (D-CA) and Gregg Harper (R-MS) envision that the Medicare Telehealth Parity Act would be rolled out in three stages. Harper introduced a similar bill last year. It’s a move that comes as states and associations take a hard look at ways to address an expanding insured population, many of its members with chronic conditions, with a declining number of physicians to treat them.

Phase one expands telehealth services under Medicare for video conferencing and store-and-forward technologies such as images, patient data and video conferencing that are sent to another site for evaluation. It would expand these services to federally qualified health centers, rural health clinics and in counties within metropolitan areas with populations less than 50,000. It would also expand telehealth coverage for certified diabetes educators, speech language therapists, audiologists, respiratory therapists, occupational therapists and physical therapists. It also calls for remote-patient monitoring for diabetes, congestive heart failure and chronic obstructive pulmonary disease to be covered in this phase.

In the second phase, the population areas covered are widened to those with 50,000 to 100,000 people. Video conferencing is extended to homes for home health services and agencies, durable medical equipment, home dialysis and hospice. In Phase three, coverage is expanded to metropolitan areas with more than 100,000 people.

The bill would also authorize the Government Accountability Office to assess the cost and clinical effectiveness of the proposed changes.

The legislation has been referred to the House Energy and Commerce Committee and the House Committee on Ways and Means. But with Congress adjourned until September and midterm elections to prepare for, no significant action is likely until the start of next year.

companion bill was introduced in the Senate this week by U.S. Senators Thad Cochran and Roger Wicker — Republicans from Mississippi.

Other groups are looking for ways to make it easier to expand telemedicine at the state level. The Federation of State Medical Boards is readying a compact that would make it easier to practice medicine across state lines with participating states. It’s expected to be ready to be reviewed by state medical boards at the end of the summer. States have also been reviewing telemedicine proposals, according to data from the American Telemedicine Association.