ATA has been working with an important bi-partisan coalition that has a goal to bring “21st Century Cures” to the United States. In comments submitted yesterday to the House Energy and Commerce Committee, ATA recommended that Congress take immediate action to improve coverage for telehealth services under Medicare payment innovations in a number of areas from fee-for-services to the accountable care organization and bundled payment programs. The comments were in response to a draft proposal on telehealth prepared by a workgroup of eight members of the House and Energy Commerce Committee.
The Committee just released its almost 400 page draft bill (http://energycommerce.house.gov/sites/republicans.energycommerce.house.gov/files/114/Analysis/Cures/20150127-Cures-Discussion-Document.pdf) with telehealth addressed on pages 291-299 directing the Centers for Medicare and Medicaid Services to implement a methodology for Medicare to cover telehealth without a net increase in spending. Of immediate benefit would be a provision to fully cover telehealth for purposes of all related Medicare demonstrations and models. More information on “21
For 2015, the list of procedure codes covered for Medicare telehealth services is (by CPT or HCPCS codes)--
90791 - 90792: Psychiatric diagnostic interview examination
90832 – 90834 and 90836 – 90838: Individual psychotherapy
90846 - 90847: Family psychotherapy
90951 - 90952, 90954 - 90955, 90957 - 90958, and 90960 - 90961: End-Stage Renal Disease-related services included in the monthly capitation payment
96116: Neurobehavioral status examination
96150 – 96154: Individual and group health and behavior assessment and intervention
97802 – 97804 and G0270: Individual and group medical nutrition therapy
99201 – 99215: Office or other outpatient visits
99231 – 99233: Subsequent hospital care services, with the limitation of 1 telehealth visit every 3 days
99307 – 99310: Subsequent nursing facility care services, with the limitation of 1 telehealth visit every 30 days
99354 - 99355: Prolonged service in the office or other outpatient setting requiring direct patient contact beyond the usual service
99406 - 99407 and G0436 - G0437: Smoking cessation services
ATA gratefully acknowledges that after three years, the Centers for Medicare and Medicaid Services (CMS) finally answered ATA’s petitions and may soon allow Accountable Care Organizations (ACOs) to use telehealth to keep their patients healthy.
In proposed rulemaking, CMS indicated an openness to cover telehealth services under the payment innovation of Medicare’s ACOs.
For several years, ATA has urged the Secretary of Health and Human Services to waive certain restrictions on ACOs use of telemedicine, thereby expanding telehealth coverage to the 80% of Medicare beneficiaries who reside in metropolitan areas, and also to all beneficiaries who receive treatment their homes (or in locations other than one of the previously designated types of health facilities).
CMS is currently seeking public comment on the proposed rule (available at http://www.gpo.gov/fdsys/pkg/FR-2014-12-08/pdf/2014-28388.pdf
We are ready to start a pilot study in SNF, targeting patients with 2 or more chronic conditions, using remote monitoring( pulse ox, BP, HR, EtCO2, noninvasive cardiac monitoring( CO, CI, PVR).
Need suggestions on what type of data, should we collect, to make a strong case for physicians and for the payers as well.
Please send me your ideas. Thank you.
Calling all telemedicine & telehealth service provider companies!
The Arizona Telemedicine Program has just rolled out a directory specifically aimed at healthcare administrators who are looking for medical specialty providers to help expand their offerings to their patients/clients and create better healthcare outcomes in their communities. The directory was created to advance telehealth partnerships.
If your company employs medical and clinical professionals and provides services such as telestroke, telepsychiatry, or teledermatology, to clients such as healthcare systems, schools, or employers, then this directory is for you.
The directory is at http://telemedicine.arizona.edu/servicedirectory. Because the directory is a public service, there is no charge associated with listing your company. Go to https://www.surveymonkey.com/s/ATPTTSPD to join the directory.
The survey is detailed in order to provide enough information for directory users to find their best fit. The directory is searchable by state, services offered, customer type, and company name so decision-makers from hospitals, clinics, schools, correctional facilities, nursing homes, employers, insurers and other entities can easily find what they need.
Late this afternoon, the Centers for Medicare and Medicaid Services issued an almost 1200-page rulemaking about 2015 Medicare payment to physicians and practitioners.
For telehealth, 7 new procedure codes will be covered for—
- annual wellness visits (HCPCS codes G0438 and G0439)
- psychotherapy services (CPT codes 90845, 90846, and 90847)
- prolonged services in the office (CPT codes 99354 and 99355)
The originating site facility fee will be $24.83.
Also, Medicare will begin paying physicians for chronic care management using a new procedure code, CPT code 99490.
In what could be an opportunity for advancing telemedicine use, the CMS Innovation Center just announced a new funding initiative to support clinicians in sharing, adapting and further developing comprehensive quality improvement strategies, which are expected to lead to greater improvements in patient health and reduction in health care costs.
CMS will award cooperative agreement funding for 2 network systems
- The Practice Transformation Networks are peer-based learning networks designed to coach, mentor and assist clinicians in developing core competencies specific to practice transformation. This approach allows clinician practices to become actively engaged in the transformation and ensures collaboration among a broad community of practices that creates, promotes, and sustains learning and improvement across the health care system.
- The Support and Alignment Networks will provide a system for workforce development utilizing national and regional professional associations and public-private partnerships that are currently working in practice transformation efforts. Utilizing existing and emerging tools (e.g., continuing medical education, maintenance of certification, core competency development) these networks will help ensure sustainability of these efforts. These will especially support the recruitment of clinician practices serving small, rural and medically underserved communities and play an active role in the alignment of new learning.
We are starting our telehealth program with our hospital as the main hub. We will be associate with rural hospitals to provided neuro consults in the ER and inpatient settings. Does anyone have information on how they cover the consent to treat that patient that is in the rural hospitals.
WASHINGTON – Monday, September 8, 2014 - The American Telemedicine Association (ATA) today released two critical state policy reports which identify gaps in coverage and reimbursement, and in physician practice standards and licensure. These first-of-their-kind reports identify and compare state policies on a report card, assigning each state grades ranging from A-to-F based on telemedicine reimbursement and physician practice standards. ATA has captured the complex policy landscape of 50 states with differing telemedicine policies, and translated the data into an easy-to-use format.
“We hope these reports serve a dual purpose: to showcase the states that are doing an excellent job when it comes to telemedicine, and to serve as a wake-up call to those who are failing to extend quality and affordable care to the residents of their state,” said Jonathan Linkous, CEO of ATA. “We hope that states will respond by streamlining policies to improve medical practice rules, licensure, healthcare quality, and reduce costs through accelerated telemedicine adoption.”
50 State Telemedicine Gaps Analysis – Coverage & Reimbursement
The first report reviewed and compared telemedicine coverage and
Over 200 counties have had some portion of their county lose eligibility for the Federal Communication Commission's Rural Health Care (RHC) Program definition of "rural area" has not
changed, but the designation of rural census tracts was routinely updated based on the 2010 census and other new data.
For information about these changes, please see http://www.usac.org/rhc/tools/news/default.aspx#1072.
The Eligible Rural Areas Search website is at http://www.usac.org/rhc/telecommunications/tools/Rural/search/search.asp.
The next webinar about the RHC program will be September 18 (register at https://attendee.gotowebinar.com/register/1150473249088342529).
During today's webcast, This Month in Telemedicine, I used PowerPoint slides to compare the incremental Medicare provisions of major telehealth bills pending in Congress. The slides were based on a one-pager you can get at
Less than One Week to Save on Fall Forum Registration:
The early-bird deadline to register for the ATA Fall Forum (Sept. 6-9, Palm Desert, Calif.) is this Friday, August 8! We invite you to register today at the member, early-bird rate and join your colleagues for two full days of program related to telehealth in chronic care, a half-day forum focused on telemedicine opportunities in China, and golf and tennis outings at the magnificent JW Marriott Desert Springs Resort and Spa. In addition, several round table discussions will cover hot-topic areas and a state-of-the-art trade show will feature the leading technologies for chronic care management. Register and find more info at www.ATAFallForum.org
ATA Applauds Bill on Medicare Telemedicine Improvement:
Last week, Reps. Mike Thompson (D-CA), Gregg Harper (R-MS), and Peter Welch (D-VT) introduced H.R. 5380, the Medicare Telehealth Parity Act of 2014, which improves telemedicine coverage in Medicare. H.R. 5380 creates a phased approach over four years to expand coverage of telemedicine-provided services and remove arbitrary barriers that limit access to services for Medicare beneficiaries. Included in these provisions are the gradual removal of geographic restrictions to patient care, and the addition of coverage for healthcare services that take place in other locations such as the home and walk-in retail health clinics. Read more here:
Less than Two Weeks to Save on Fall Forum Registration:
The early-bird deadline to register for the ATA Fall Forum (Sept. 6-9, Palm Desert, Calif.) is next Friday, August 8! We invite you to register today at the member, early-bird rate and join your colleagues for two full days of program related to telehealth in chronic care, a half-day forum focused on telemedicine opportunities in China, and golf and tennis outings at the magnificent JW Marriott Desert Springs Resort and Spa. In addition, several roundtable discussions will cover hot-topic areas including:
- Internal Awareness and Adoption
- Telehealth and Network Deployment
- Business Models and Sustainability
- State Policy
- Surgical Telementoring
- and a Telemedicine Service Provider Forum
More info at www.ATAFallForum.org
Online, Direct to Consumer Patient Consultations Becoming Mainstream:
Join us tomorrow from 2 - 3 p.m. EDT as ATA CEO Jonathan Linkous and Senior Policy Director Gary Capistrant cover breaking telemedicine policy and industry developments during a live webcast of This Month in Telemedicine. Post your questions in the comments field below and tune in for the answers live tomorrow!
Access the webcast here
There are now 120 Members of Congress on one or both of
the 2 pending bipartisan bills to expand the "one state license" to
other Federal interstate telehealth. With these bills a health care
professional would need only one state license to serve patients
anywhere who are covered a specific federal health program.
Please urge your Representative to join the list of sponsors below.
The bills are--
There are no Senate companion bills at this time -- so there is an opening for your Senators.
- H.R. 2001 for the Department of Veterans Affairs
with the VETS Act (Veterans E-Health & Telemedicine Support Act)
introduced by Charles Rangel (D) and Glenn Thompson (R) with a total of
- H.R. 3077 for Medicare with the TELE-MED
Act (TELEmedicine for MEDicare Act) introduced by Devin Nunes (R) and
Frank Pallone (D) with a total 64 sponsors
Would you be
interested in writing a 5-page printed book chapter (no more than
10-manuscript pages) about your work with technology in
behavioral or mental health?
As a team of
three editors, Marlene Maheu, Ph.D., Kenneth Drude, Ph.D., and
Shawna Wright, Ph.D., we have contracted with the second largest
mental health publisher worldwide to edit our book. It is to be
a "field guide" that is intended to inspire our
colleagues to who earn a living in whole or in part with technology.
We're asking you to show us how you managed to move from a graduate
behavioral degree to your distinguished work with technology. Our
ultimate goal then, is to publish a field guide for evidence-based
employment using technology in behavioral and mental health care.
the proposed Medicare rulemaking for 2015, the Centers for Medicare and
Medicaid Services (CMS) approved requests by the American Telemedicine
Association to expand healthcare services that are eligible for
reimbursement. These include telehealth services, remote testing and, for the first time, non-face-to-face chronic care services. They are proposed to go into effect January 1, 2015.
The 609-page notice of proposed rulemaking is available at http://www.ofr.gov/OFRUpload/OFRData/2014-15948_PI.pdf. Pages 139-150 are for telehealth services and 170-185 for chronic care management. This notice will be published in the Federal Register of July 11 and open for comment on or before September 2.
Services to be covered when provided by telehealth
See the New York Times article about the recent "model act" in support of telemedicine advanced by the Federation of State Medical Boards (FSMB).
See : http://www.nytimes.com/2014/06/30/us/medical-boards-draft-plan-to-ease-path-to-out-of-state-and-online-treatment.html?ref=health&_r=2
TeleMental Health Institute, Inc.
Telehealth parity legislation in NY has received some last minute support by its state law makers. S07852
- formerly S04337b - has been amended and passed through the Senate and Assembly with unanimous biparitsan support. The bill would still require private insurers and Medicaid to cover and reimburse for health care services delivered via telehealth. Additionally, the bill also includes coverage of services provided via store-and-forward and remote patient monitoring, as well as services provided in the home. The amended version of the bill has been returned to the Senate for consideration of further amendments or passage. If the Assembly and Senate can agree on the final language of the bill, it will be sent the Governor.
The U.S. Food and Drug Administration issued a draft guidance "Medical Device Data Systems, Medical Image Storage Devices, and Medical Image Communications Devices" available at http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm401785.htm.
This draft guidance document proposes that the Agency does not intend to enforce compliance with the regulatory controls that apply to medical device data systems (MDDS), medical image storage devices, and medical image communications devices, due to the low risk they pose to patients and the importance they play in advancing digital health. This draft would supersede FDA's February 15, 2011 regulation down-classifying MDDS to Class I (low-risk).
A period for public comment will be open until at least August 25 (the actual period will be for 60 days after the draft guidance is published in the Federal Register.)