Bill Seeks to Expand Medicare Reimbursement for Telehealth

Senators Cory Gardner (R-Colo.) and Gary Peters (D-Mich.) have introduced legislation designed to expand access to healthcare in rural areas, allowing Medicare to cover additional telehealth services.

The Telehealth Innovation and Improvement Act is an attempt to remedy the fact that Medicare currently only covers limited telehealth services, which the senators argue is “setting a poor industry standard, discouraging innovation, and restricting access to specialized services.”

The bill would require the Department of Health and Human Services to allow eligible hospitals to test telehealth services through the Center for Medicare and Medicaid Innovation (CMI). In addition, the proposed legislation directs CMI to review and independently evaluate telehealth models for cost, effectiveness, and improvement in quality of care without increasing the cost of delivery. According to provisions in the bill, if the telehealth model meets this criteria, then it would be covered by Medicare.

Also See: Legislative Support for Telemedicine Growing in Congress

“People living in rural Colorado should have access to the same health care services as those living in urban areas,” said Gardner in a written statement. “Telemedicine has the power to increase access to specialized services in underserved communities, and potentially lower costs and improve patient outcomes. The Telehealth Innovation and Improvement Act would pave the way for Medicare to expand coverage to additional telehealth services, and potentially provide those living with life-threatening conditions in rural America with more opportunities and more options to receive the care they need.”

Peter Rasmussen, M.D., medical director of distance health at Cleveland Clinic, believes that about 80 percent of urgent care demands can be served using telemedicine. In addition, he argues that certain medical specialties such as behavioral health, dermatology, as well as routine surgical follow-ups, are well-suited for telehealth and virtual visits.

“We’ve got good technology and it’s only going to get better,” he says.

Rasmussen points to Cleveland Clinic’s tele-stroke network, which provides emergency evaluations for patients in ERs in northeast Ohio and western Pennsylvania, as an example of the kinds of implementations that can benefit rural areas in particular.

“It’s going to be less expensive in the long-term to provide telehealth services this way,” he argues. “The real opportunity in all of this is in the development of virtual disease management programs for things like managing chronic hypertension and diabetes through remote monitoring and care coordinators, and minimizing the number of actual bricks-and-mortar visits that they have to undergo.”