ATA works Capitol Hill to increase telemedicine coverage
The American Telemedicine Association is actively pursuing reforms on Capitol Hill to expand Medicare coverage of telemedicine.
In partnership with 12 other organizations, the association recently sent a letter to the House Energy and Commerce Committee rallying legislators to increase telehealth coverage, said Gary Capistrant, senior director of public policy at the ATA, during the association’s monthly webcast on Sept. 30.
In the letter, it outlined specific areas where it is looking to expand Medicare coverage of telehealth:
- ACOs
- Bundled payments of acute and post-acute episodes
- All federally qualified health centers
- All critical access hospitals
- Remote patient monitoring starting with congestive heart failure, chronic obstructive pulmonary disease and diabetes
- Home dialysis patients
Some regulations are expected soon that would waive Medicare restrictions on telehealth for ACOs. However, they have been stalled by the Congressional Budget Office’s concerns about additions to fee-for-service. “We had to be true, strategic and incremental to develop these proposals,” he said.
Physician payment reform is still needed, and these items could end up as part of a legislative package. Also, they could be rolled into the Energy and Commerce Committee’s 21st Century Cures Initiative, for which legislators are working to keep regulations in pace with technological advancements, he said. “There could be high possibilities for Congressional action this year.”
The Centers for Medicare & Medicaid Services proposed payment for chronic care management (for patients with two of more conditions) for 2015, and ATA is pushing for CPT codes to cover remote monitoring for the purposes of collecting physiological data.
“It’s important that CMS allow this code to be part of what can be bundled with CPT 99091 [Code for collecting and reviewing data]. It’s a little over $100 per month for chronic care,” he said.
ATA also is promoting its two reports that rank and report on each state’s progress on telemedicine coverage and reimbursement. “We directly sent something out to all Medicaid offices to be aware of it. It’s getting important visibility,” Capistrant said.
One report looks at coverage and reimbursement standards for every state based on 13 indicators related to coverage and reimbursement, while the second report reviewed and compared physician practice standards and licensure for telemedicine in every state.
“It’s been a labor of love,” said Latoya Thomas, project director for state health policy at ATA, during a summary of the reports. The association will regularly update them as regulations change. Currently 10 states are considering regulation that will affect telemedicine, she said.