2015 was a huge year for telemedicine policy, with more than 200 telemedicine bills introduced in state legislatures nationwide. That includes at least one telemedicine-related bill for all but eight states!
Trying to keep up with all that legislation may make your head spin. That’s why we’ve put together this update on the two major telemedicine policies going through state and federal governments today.
Breaking Down Interstate Licensure Barriers
One of the key regulatory barriers to the growth of telemedicine is medical licensing. Traditional medical licensing requirements don’t allow the kind of flexibility and access across state lines that is the core purpose of telemedicine.
In 2014, the Federation of State Medical Boards (FSMB) launched the Interstate Medical Licensure Compact in the hopes of streamlining and expediting this licensure process across state lines. The Compact would make it much easier for doctors to consult patients in other states remotely.
The document included eight key points, including that participation would be voluntary for physicians and state boards of medicine. A number of prominent medical organizations have since endorsed the Compact, from the American Medical Association to the National Stroke Association.
As of December 2015, 12 states had already enacted the compact: Alabama, Idaho, Illinois, Iowa, Minnesota, Montana, Nevada, South Dakota, Utah, West Virginia, Wisconsin, and Wyoming. FSMB announced last month that another six states have introduced legislation to support the compact: Alaska, Arizona, Colorado, Kansas, New Hampshire, and Washington.
However, Jonathan Linkous, CEO of the American Telemedicine Association, told MobiHealthNews he doesn’t believe the compact is adequate to serve telemedicine physicians’ needs. “The physician would still have to pay a fee to every state, probably [also] a processing fee, and have a third party handle the paperwork, which may or may not be a good thing. And we don’t know if all the states will adopt it,” Linkous said. The bottom line? The Compact is a huge step in the right direction, but there’s still work to be done.
Could telemedicine become a standard benefit for Medicare patients this year?
The Telemedicine for Medicare Act of 2015 (TELE-MED Act – House/Senate bill) didn’t make it out of committee and to a Senate or House floor vote last year, nor did the Telemedicine for Medicare Act of 2013. These bills would help physicians provide telemedicine care to Medicare patients across long distances and state lines.
However, the new year has brought some exciting news! Congress has just introduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act (House bill). This act takes a three-pronged approach to improving access to telemedicine:
- Creates a “bridge program” where doctors can take part in the Merit-based Incentive Payment System (MIPS) to obtain exemptions from Medicare restrictions on telemedicine coverage by applying for demonstration waivers
- Automatically lifts those restrictions for participants in alternative payment models (ACOs, etc.)
- Expands coverage of remote patient monitoring technologies to enable physicians to better treat patients with chronic illnesses
CONNECT would also expand telemedicine reimbursement options for non-hospital sites, such as telestroke evaluation and management sites, Native American health service facilities, dialysis facilities, community health centers, and rural health clinics.
To receive the mentioned waiver, physicians would have to submit an application with a detailed plan for their telemedicine services and agree to random audits that would monitor correct use of the technology and prevent over-utilization. This isn’t much of a surprise since Medicare wants to facilitate doctor’s visits for patients who can’t make it into the office or hospital—but not drastically increase Medicare spending.
Washington think tank Third Way estimates savings of $1.8 billion for the Medicare program through this bill. The waiver program actually increases federal spending by $1.1 billion, but the other two provisions are expected to generate enough savings to offset those waiver costs.
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