ATA asks HHS to lift 'unnecessary' restrictions on Medicare providers

The American Telemedicine Association (ATA) is asking the Department of Health and Human Services to remove telemedicine restrictions on accountable care organizations and other "unnecessary" limitations on Medicare providers.

In a letter to Health and Human Services Secretary Kathleen Sebelius, ATA asks the government to:

  • Waive the Medicare restrictions on telehealth for ACOs and Center for Medicare and Medicaid Innovation (CMMI) payment models for bundled acute care and medical homes 
  • Allow alternative payment methods to promote home telehealth and remote monitoring for "homebound" Medicare beneficiaries

"Providers cannot take advantage of the full capabilities of telemedicine and telehealth due to unnecessary limitations," said Jonathan Linkous, chief executive officer of ATA, in an announcement. "The current language creates artificial barriers to care including patient location restrictions, communications technology restrictions, and it also defines a narrow list of eligible providers and covered services."

The letter's authors write that 80 percent of Medicare beneficiaries live in about 1,200 metropolitan counties that are not covered. "Store-and-forward" services, such as for transmission of medical images, are not covered in the Lower 48 states; nor are services that originate from the beneficiary's home.

The letter particularly calls for coverage of remote monitoring of patients with multiple chronic conditions in their homes.

Medicare's 2014 physician fee schedule expands coverage for telehealth services to what the ATA calls "the fringes of metropolitan areas." It said the proposed rules were an "incremental" step.

A bill expanding coverage for members of the military passed in January and a similar bill allowing Medicare providers to practice across state lines passed the House last fall.

Meanwhile, states are pushing adoption of telehealth through "parity" laws requiring equal coverage as that offered through in-person visits.

To learn more:
- read the letter (.pdf)
- here's the announcement

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