Industry groups to Congress: Telemedicine licensing 'out of date'

A pair of industry groups put pressure on Congress to update "out-of-date" licensing and reimbursement policies for telemedicine.

In letters sent this week to members of the House Energy and Commerce Committee's subcommittee on Health, the American Telemedicine Association and Health IT Now both encourage passage of the Telehealth for Medicare (TELE-MED) Act of 2013, saying the legislation would increase patient access to healthcare by enabling Medicare providers to practice across state lines without having to obtain another license.

ATA calls for telemedicine services to be covered and reimbursed "comparable to in-person visits," and refers to disparate state-by-state licensures as "artificial barriers." It also calls for the subcommittee--chaired by Rep. Joe Pitts (R-Pa.)--to obtain a budget estimate for the provisions in the TELE-MED Act from the Congressional Budget Office.

ATA estimates that state licenses cost physicians $300 million annually in fees and administrative time.

Additionally, ATA expresses support for the Telehealth Enhancement Act of 2013, pointing out that it would like to see Medicare accountable care organizations granted the ability to use telehealth without fee-for-service restrictions, similar to what Medicare Advantage plans are allowed. It also calls for incentives for fewer Medicare hospital readmissions, saying that "a 'carrot' of shared savings would recognize a hospital's additional costs for better performance," such as those brought on by the use of remote patient monitoring.

Health IT Now, in addition to pushing for action on the TELE-MED Act, says it wants the committee to commission a public-private task force to further examine the issue of state licensure. It also calls for a national common definition and guidelines for telemedicine, per measures within the Telehealth Modernization Act, introduced in December.

A study published in the May issue of Telemedicine and e-Health calls federal efforts to define and advance telehealth a work in progress; it counts seven unique definitions of telehealth in current use across the U.S. government.

Health IT Now also says Congress must establish a timeline to achieve "semantic interoperability" by 2017. Specifically, the group wants to see the prohibition of use of information blocking or closed application programming interfaces within federal programs, such as the Meaningful Use Incentive Program. Health IT Now calls for Congress to fund collaborative efforts with private sector partners to achieve the interoperability goal.

Earlier this month, ONC unveiled a 10-year plan to achieve healthcare interoperability. Within three years, the agency says, it will have developed an interoperability roadmap by scaling current health information exchange approaches "across vendor platforms" to support transitions of care and public health. ONC plans to focus heavily on query-based data exchange and point-to-point information sharing.  

A third industry group--the Telecommunications Industry Association--also calls for increased investments in telehealth, as well as an update to licensing policies, in its own letter to the subcommittee.

"Telehealth and remote patient monitoring continue to change the way that healthcare is delivered and consumed," TIA says in its letter. "As we continue to look forward, it is imperative that we have policies and practices in place that enable the development of this important industry."

To learn more:
- here's the ATA's letter (.pdf)
- check out Health IT Now's letter (.pdf)
- read TIA's letter (.pdf)