On February 3, 2016, Senators Brian Schatz (D-Hawaii), Roger Wicker (R-Miss.), Thad Cochran (R-Miss.), Ben Cardin (D-Md.), John Thune (R-S.D.), and Mark Warner (D-Va.) introduced a bipartisan bill that would expand telehealth services through Medicare titled “Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act.” Telehealth is the delivery of health-related services and information through telecommunications. The purpose of the legislation is to improve healthcare outcomes and reduce costs for patients and providers, according to Senator Schatz’s press release.
42 U.S.C. § 1834(m) outlines the current Medicare payment requirements for telehealth services. A summary of the CONNECT for Health Act released by Senator Schatz explains that 42 U.S.C. §1834(m) constrains telehealth reimbursement by imposing:
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Originating site restrictions;
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Geographic limitations;
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Restrictions on store-and-forward technologies;
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Limitations on distant site providers; and
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Limitations on covered codes.
Senator Schatz’s summary outlines how the CONNECT for Health Act would, among other things:
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Create a bridge program to help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the aforementioned § 1834(m) restrictions;
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Allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the aforementioned § 1834(m) restrictions;
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Permit the use of remote patient monitoring for certain patients with chronic conditions;
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Allow, as originating sites, telestroke evaluation and management sites; Native American health service facilities; and dialysis facilities for home dialysis patients in certain cases;
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Permit further telehealth and RPM in community health centers and rural health clinics;
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Allow telehealth and RPM to be basic benefits in Medicare Advantage, without most of the aforementioned § 1834(m) restrictions; and
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Clarify that the provision of telehealth or RPM technologies made under Medicare by a health care provider for the purpose of furnishing these services shall not be considered “remuneration.”
Reporter, Stephanie F. Johnson, Atlanta, +1 404 572-4629, sfjohnson@kslaw.com.
