HIT coalition pushes CMS to revamp telehealth policies

Health IT Now, a coalition of patient groups, providers, employers and insurers, in large part agrees with new IT policies included in a recently issued proposed rule making changes to payment policies under the physician fee schedule for Calendar Year 2018.

However, the organization also has some serious concerns, particularly regarding telehealth policy, which it detailed in a comment letter sent to CMS Administrator Seema Verma.

The group sees the IT measures as fostering improved patient safety and outcomes by giving providers, patients and caregivers tools that will better enable them to manage health and wellness.

For example, the coalition strongly backs proposed additions to covered telehealth services and is encouraging CMS to go further by offering Medicare reimbursement for physical, occupational and speech-language therapy, while also adding diabetes educators to the list of providers eligible to bill for telehealth services.

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Health IT Now recognizes that Medicare requirements that cover the use of telehealth are woefully out of date largely because of congressional restrictions imposed in 1997, the group told CMS.

“Providers are not allowed the flexibility to design telehealth benefits in a way that works best for them and their patients. The result is that in 2015, Medicare spent $28.75 million out of $646 billion, or less than 1 percent, on services delivered via telehealth.”

CMS also must address physician licensure barriers related to telehealth as physicians currently must be licensed in the state where the patient is located, which is reducing access to specialist care for persons with chronic conditions, the organization contends. CMS should follow the model of the Departments of Defense and Veterans Affairs in not requiring physicians to obtain additional state licenses.

Under the Appropriate Use Criteria program that CMS has developed but has delayed implementation, physicians must consult appropriate use criteria (evidence-based best practices) before ordering advanced diagnostic imaging tests.

However, Health IT Now worries about a lack of tools for providers to successfully comply, as well as the lack of interoperability between electronic health records and clinical decision support systems. “Until the health IT marketplace is rid of disincentives for information sharing, HITN strongly objects to exacerbating the problem with additional requirements,” the organization asserts.

Health IT Now supports CMS’ commitment to lowering diabetes rates in the Medicare population, but disagrees with the agency’s decision to not cover provisions of the Diabetes Prevention Program via use of technology tools. Innovators, the group says, continue to find new ways to bridge distance in bringing care to patients while CMS continues to lag all other payers in using technology to deliver health care.

The complete comment letter is available here.