Proposed Federal Law Could Save Medicare an Estimated $1.8 billon

A bipartisan group of US Senators led by Brian Schatz (D-HI) has introduced legislation that would enable an expansion of telemedicine services covered by Medicare, and could result in substantial cost savings.

The bill’s other sponsors are Senators Ben Cardin (D-MD), Thad Cochran (R-MS), John Thune (R-SD), Mark Warner (D-VA), and Roger Wicker (R-MS).

The bill, the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, contains three significant policy changes that would serve to increase use of telehealth technologies:

Title one of the bill would establish a “bridge program” that allows doctors participating in the Merit-based Incentive Payment System (MIPS) to apply for demonstration waivers that would exempt them from restrictions Medicare imposes on the coverage of telehealth,
Title two would cover telehealth and remote patient monitoring (RPM) for provider participants in Alternative Payment Models (such as Accountable Care Organizations-ACOs, Patient Centered Medical Homes-PCMHs, etc., and
Title three would provide for coverage of RPM technologies for patients with chronic conditions to fee-for-service physicians and practitioners, whether or not they participate in Medicare quality and value improvement programs.

The waiver program under Title one seeks to ensure that telehealth services will be largely replacing in-office services, so that Medicare spending does not increase. In order to receive a waiver, providers must submit an application detailing how they plan to use telemedicine, and be subject to random audits to assess whether they’re using telemedicine in a way that’s consistent with MIPS goals.

The estimated savings of $1.8 billion is the conclusion of a cost analysis that was commissioned by Washington DC-based think tank, Third Way, and was conducted by Avalere, a health care consulting firm.

Click here to read the Senate bill

Click here to read more of the Avalere report

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