The Push For Telehealth Reimbursement: Advocates Lobby CMS

In a year during which efforts to expand Medicare reimbursement for telehealth services have gained new momentum, more and more advocates are taking their case directly to the Centers for Medicare and Medicaid Services (CMS). As mHealth Intelligence first reported, a variety of different health care advocacy organizations have submitted comments to the agency in support of additional reimbursement for telehealth and remote patient monitoring. “HIMSS encourages CMS to embrace a reimbursement system that recognizes the unique characteristics of connected health that enhances the care experience for the patient, providers and caregivers,” the Healthcare Information and Management Systems Society (HIMSS) wrote in a letter to the agency. “Medicare patients should have the advantage of utilizing technologies that allow them more time away from healthcare facilities, proactive control of their care, improved access to their records and health data, and the tools that make that data come alive.”

The other groups that submitted comments in response to the agency’s call for feedback on its proposed 2018 physician fee schedule included the American Medical Informatics Association (AMIA), the Center for Connected Health Policy (CCHP), the American Medical Association (AMA), and the American Medical Group Association (AMGA). “The AMA strongly supports CMS’ proposal to provide telehealth coverage to seven new codes and urges CMS to expand coverage to unbundled remote monitoring services,” AMA leadership wrote in its letter to CMS Administrator Seema Verma. For its part, the AMIA weighed in, as it has in the past, on the importance of broadband coverage for the delivery of telehealth and other services. Earlier this year, the organization called broadband access “a social determinant of health,” and noted in their recent letter to CMS that the agency “can play a role in strengthening this social determinant by working with the FCC to assess broadband connectivity in rural” communities.

Through the Telehealth Reimbursement Coalition, CTeL and its partners have also been working to make a research-based case to the Congressional Budget Office (CBO) for expanded federal telehealth reimbursement. And many of the more than two dozen telehealth-related bills introduced in the current Congress specifically target Medicare restrictions. The bipartisan Evidence-Based Telehealth Expansion Act, for example, would authorize the Health and Human Services (HHS) Secretary to, upon review, waive certain current restrictions on Medicare telehealth reimbursement. Similarly, the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act would remove a number of current Medicare restrictions on telehealth and remote monitoring services. Bolstering the case for these bills and advocates’ lobbying efforts: the April Government Accountability Office (GAO) study asserting that outdated Medicare reimbursement policies and other coverage limitations are standing in the way of wider utilization.

Click here to read the mHealth Intelligence article on efforts to expand Medicare telehealth reimbursement.

Click here to read comments from HIMSS on expanded Medicare telehealth reimbursement.

Click here to read comments from the AMA on expanded Medicare telehealth reimbursement.

Click here to read comments from the AMIA on expanded Medicare telehealth reimbursement.

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