March 9, 2014

Telemedicine Use May Be Expanded by Medicare

I am not sure this will happen or when, but this is what is reported in MedPage Today back in December 2013. “Medicare officials and members of Congress are taking steps to expand the use of telemedicine services by dropping -- or proposing to drop -- restrictions on their use.”

I was not sure so I have held this until I could hear back from my representative. He was not aware of this and had not seen any proposed legislation. He did state that it could be part of the 'doc-fix' bill that is currently stalled, but he had not reviewed it and would not until it became actionable.

The MedPage Today article said the following, “Both the 2014 Medicare physician fee schedule and legislation to repeal the program's sustainable growth rate (SGR) payment formula have provisions designed to improve access to telemedicine.”

"Many of the states [through Medicaid] do a much better job of using telehealth than does the Medicare program," Gary Capistrant, senior director of public policy at the American Telemedicine Association, told MedPage Today. "Medicare may be the last to move forward."

Currently only 20 states and the District of Columbia require that private insurers cover telehealth the same as they cover in-person services. When Medicare started paying for services delivered through telemedicine systems, it was limited to patients in rural, underserved areas who had a Medicare provider present with them. This was very restrictive and limiting.

Medicare's Sustainable Growth Rate (SGR) restricts the growth of telemedicine and technology's use. Even if Congress passes the doc-fix and repeals the SGR, the government will still need to get out of the way and allow providers to perform their duties.

Until the bills are passed, we will have no improved method for the expansion of telemedicine. There are still barriers in the current laws and Congress is not currently considering removing these barriers. Capistrant says, "We need to move rapidly to a system where we're just talking healthcare, and not special restrictions on the use of technology for health."

I am concerned that Congress will work piecemeal at fixing the barriers to telemedicine, thereby making telemedicine not effective for several years. 

Note:  Unless this is separated from the SGR, it is basically a dead issue for this year. 

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