One Nation Under Coverage

The American Telemedicine Association, along with 11 other Health Systems and groups such as HIMSS and Continua, are imploring congress to evaluate current laws regarding telemedicine. Cited in their letter to Chairman Fred Upton and Representative Diana DeGette, the groups urge that, “Telehealth and remote patient monitoring should be the cornerstone of a 21st Century healthcare system and should be a covered benefit. Congress has the responsibility to take necessary steps to help Americans realize the benefits of these solutions.”

The groups recommend 4 different actions that Congress can take to help give Americans better access to this kind of care:

♦ Authorize the use of telehealth for all accountable care organizations and bundled payments program;

♦ Authorize remote patient monitoring for congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD), and, in the case of federally qualified health centers (FQHCs), diabetes, along with flexibility  for further expansion for eligible chronic conditions identified by the secretary based on an annual review of the evidence;

♦ Authorize the use of telehealth payments for population health management to include all critical access hospitals and FQHCs; and

♦ Facilitate care for Medicare patients by allowing video visits and remote monitoring, such as for home-based kidney dialysis patients.

Medicaid and Medicare are gray areas when trying to get reimbursement for using telehealth or telemedicine services. The inability to receive such reimbursement has also inhibited the reach of telehealth services, even though at least 70% of patients are interested in virtual consultations with their doctors. The convenience of telemedicine for our fast-paced world is revolutionary, including benefits to patients such as increased quality of care, reduced hospitalization, avoidance of complications and improved satisfaction, particularly for the chronically ill, and reduced costs.  Restrictions in laws such as Section 1834(m) of the Social Security Act particularly limit access to these new technologies based upon where the patient lives.

The single notion that is prevalent in our healthcare system today is limited access to care.  With growing technologies like telemedicine, access to care is already in place.  The chance to video conference with a doctor from the privacy of your own home is in higher demand than ever before.  The ability to be covered through these innovative services should not have to wait.  Hopefully Congress will understand that Americans should not only have the ability, but the right to be covered with Medicare and Medicaid using telemedicine.

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