Hospitals to Congress: 21st Century Cures telemedicine provisions don't go far enough

Provisions on improving Medicare's telehealth policy featured in a recently released discussion document by the House Energy and Commerce Committee are a step in the right direction, but don't go far enough, according to a letter from the American Hospital Association to committee chairman Rep. Fred Upton (R-Mich.).

The policy is part of the House committee's 21st Century Cures initiative, which on Tuesday released a broad, overarching document for comment; the goal is to winnow the document down into a bill that can be sent to President Barack Obama by the end of the year.

The AHA's comments specifically refer to the "Advancing Telehealth Opportunities in Medicare" proposal. The provision calls for the U.S. Department of Health and Human Services to create a methodology that would expand coverage and payment for telehealth services.

However, the AHA finds fault with one aspect of the proposal: It will only apply if the Centers for Medicare & Medicaid Services finds that the services "would reduce [or would not result in any increase in] net program spending under this title," the document says.

The proposal does not address technology limitations in the Medicare program, nor does it address how remote monitoring will be paid for, according to the AHA.

"We also are concerned that the requirement for the Medicare actuary to certify telehealth cost neutrality for specific services would be hard for HHS to operationalize, and would add a time consuming step when technology is advancing at a rapid pace," the letter states.

CMS, in the fall, expanded telemedicine coverage for Medicare beneficiaries via an update to the Medicare Physician Fee Schedule for 2015.

The AHA also says that evidence exists to show that using telemedicine services is financially viable and improves care. It points to its telemedicine Trend Watch report--published this month--as proof.

In the report, AHA finds that tele-ICU programs can help hospitals supplement clinician staffing of their ICU beds and that patients are embracing the use of telemedicine for care.

The AHA says it agrees with the committee's "goal of expanding coverage of telehealth services in Medicare, and appreciates the specification of a mechanism for doing so," but adds that a more global approach is needed.  

To learn more:
- read the AHA's letter (.pdf)
- here's the Trend Watch report (.pdf)

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