Telemedicine Scores More Medicare Coverage

Telemedicine continues to grow rapidly in popularity as patient demand has increased and the technology for providing it continues to advance. For a sense of its exponential growth, consider this: Medicare paid out a total of $61,302 for telemedicine services in 2001, and more than $17.6 million for the services in 2015. However, even with that incredible growth, telemedicine still makes up a miniscule amount of the over $600 billion Medicare budget due to the limits on what Medicare will pay for telehealth services. But this stance on telemedicine coverage is slowly beginning to change.

In March of this year, Congress passed the Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act (“the Chronic Care Act”) as part of the House and Senate budget deal to keep the federal government funded. As part of the Chronic Care Act, several telemedicine programs will receive increased reimbursement from Medicare. For example, telemedicine services allowing rural general practitioners to consult remotely with specialists from other, often far away, sites to treat a patient in need of immediate specialist care will now be covered by Medicare. Taking effect within two years of the 21st  Century Cures Act, which also expanded coverage for telemedicine services, the Chronic Care Act can be seen as a trend towards more fully utilizing technological advances.

For further evidence of this growing trend, the following legislation has surfaced within the past two years: the Medicare Telehealth Parity Act of 2017; the Helping Expand Access to Rural Telemedicine (HEART) Act; the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017; the Telehealth Enhancement Act of 2017; the Evidence-Based Telehealth Expansion Act of 2017; the Medicare Pilot Program; and the Telehealth Innovation and Improvement Act of 2017.

As telemedicine continues to expand in popularity and garner more Medicare coverage, it also continues to raise questions. Issues related to technology, regulation, data security and reimbursement have and will continue to arise, as will concerns over how these telemedicine transactions can translate into face-to-face care in situations where telemedicine simply cannot provide what is needed. Throughout this ongoing expansion, it is important to keep track of changes in the law as they relate to all of these facets of telemedicine. If you have any questions on the expansion of telemedicine, the services that are reimbursable, or are a provider interested in offering such services, contact an experienced healthcare attorney to discuss this ever-changing field.