Cost overestimates by CBO hinder telehealth coverage, healthcare professionals say

Some healthcare professionals say the Congressional Budget Office's history of overestimating the cost of new Medicare services poses a hindrance to expanded coverage for telemedicine, according to Politico.

The CBO puts a cost estimate on proposed legislation--in this case, several bills expanding Medicare coverage for remote care.

Critics of the CBO point to four instances in which it overestimated new programs: creation of the prospective payment system; the Part D drug program; the Affordable Care Act; and the Balanced Budget Act.

Congress put the current restrictions in place in 2001. At that time, CBO predicted telemedicine would cost Medicare $150 million in the first five years. However, the program has spent just $57 million over 14 years, according to the Center for Telehealth and e-Health Law (CTeL).

Former Centers for Medicare & Medicaid Services Administrator Bruce Vladeck tells Politico that CBO historically overestimates costs and underestimates savings. Another former CMS administrator, Gail Wilensky, says the critics are "cherry picking" examples based on their views--there are plenty of underestimates, as well.

The Telehealth Innovation and Improvement Act, introduced in the Senate this month, would expand Medicare coverage to telemedicine services in rural areas. The Medicare Telehealth Parity Act of 2015, introduced in the House this summer, also would remove geographic barriers.

Another bill in the Senate, the Veterans E-Health & Telemedicine Support Act of 2015 (VETS Act), would allow Department of Veterans Affairs healthcare professionals to practice across state lines and treat patients in their own homes. It mirrors a similar bill in the House.

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