elderly woman at home on telemedicine visit

New Budget Deal Boosts Telemedicine Coverage

Earlier this month, President Donald Trump signed into law a bipartisan budget deal that impacts Medicare’s telemedicine coverage more than any past legislation, as described by one senator. After a brief government shutdown, Congress approved a two-year budget deal including parts of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act, the Furthering Access to Stroke Telemedicine (FAST) Act, and the Increasing Telehealth Access to Medicare Act.

The new law targets Medicare’s telemedicine reimbursement rules by:

  • eliminating geographic restrictions on telestroke consultation services, beginning in 2019;
  • expanding telemedicine coverage under Medicare Advantage Plan B, beginning in 2020;
  • giving Accountable Care Organizations increased flexibility in using telemedicine services;
  • adding patients’ freestanding dialysis facilities to the list of originating sites, without geographic restriction, for monthly telemedicine evaluations; and
  • extending and expanding an initiative that sets up home-based primary care teams for Medicare patients who have multiple chronic conditions.

Overall, the bill augments reimbursements for telestroke and dialysis, authorizes nationwide reimbursements for telemedicine starting in 2020, and amplifies an existing home healthcare program while laying the groundwork for Remote Patient Evaluations. The legislation also prevents Meaningful Use requirements from becoming overly strict in the future, instead maintaining flexibility to allow the role of Electronic Health Records to evolve with healthcare delivery, such as integrating EHR, imaging, and other tools into telemedicine platforms on a real-time basis.

Senator Brian Schatz (D-Hawaii), an ardent supporter of telemedicine bills, expects to see improvements in access, quality of care, and health outcomes as a result of this bill, as well as reduced costs due to the use of presently available technology. He believes the largest gains will be for Medicare patients who live in rural areas or who have the most difficulty traveling to the doctor’s office, and he foresees telemedicine as playing an even larger role in healthcare in the future. Other proponents see value in including telemedicine as part of the basic care package for both rural and urban patients as they anticipate a buildup of momentum for future legislation.

With reimbursement authorized from the Centers for Medicare & Medicaid Services and restrictions eased on originating site requirements, millions of unserved Medicare beneficiaries will no longer have significant barriers to care for heart disease and stroke; these patients will have access to the treatments they need and the follow-up care that has proven critical to reduced hospital readmission rates and improved outcomes.

With our telemedicine platform already in use for real-time telestroke services, swyMed welcomes this progress; reimbursement signals a wider acceptance of telemedicine as a mainstream healthcare delivery method. Millions of Americans, many of whom live in rural regions, will have improved access to needed healthcare—options that are only made possible thanks to telemedicine.

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  1. […] So far, no enforcement actions have been taken, but whistleblowers could file complaints under the False Claims Act. To minimize this possibility, practitioners and stakeholders should familiarize themselves with Medicare telemedicine reimbursement requirements, especially considering the upcoming changes resulting from the passage of the Increasing Telehealth Access to Medicare Act and other legislation earlier this year. […]

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