Washington Debrief: Bipartisan Bill Would Expand Access to Telehealth under Medicare

Feb. 10, 2016
The bipartisan, bicameral legislation introduced last week would begin to expand Medicare reimbursement for telehealth services.

Congressional Affairs

Key Takeaway: The bipartisan, bicameral legislation introduced last week would begin to expand Medicare reimbursement for telehealth services.

Why It Matters: The CONNECT for Health Act (S.2484), would create a program that would waive for participating providers Medicare's requirement that telehealth services occur at a qualified site and other restrictions, among other policy changes to expand access to telehealth services for Medicare beneficiaries.

For Medicare providers who ultimately participate in the Merit-based Incentive Payment System (MIPS) and alternative payment models (APMs) created under the Medicare Access and CHIP Reauthorization Act (MACRA), the bill would also remove the requirement that to qualify for reimbursement, telehealth services must be provided at a qualified site. The bill also permits the use of remote patient monitoring for patients with multiple chronic conditions.

The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act was introduced in the Senate on February 3rd by Senators Brian Schatz (D-HI), Roger Wicker  (R-MS), Thad Cochran  (R-MS), Ben Cardin (D-MD), John Thune (R-SD) and Mark Warner (D-VA). The bill was introduced into the House (H.R. 4442) by Representatives Diane Black (R-TN-06), Peter Welch (D-VT-AL), Gregg Harper (R-MS-03) and Mike Thompson (D-CA-05).

The Congressional Budget Office (CBO) has traditionally cited telehealth expansion bill as costing the federal government, so this bill was crafted to show potential cost savings for Medicare through the expansion of reimbursement for telehealth services, upwards of $1.8B over 10 years according to the drafters.

Federal Affairs

Key Takeaway: CMS Publishes Two New FAQs on Meaningful Use Hardships – CHIME Boils it Down in Fact Sheet

Why it Matters: The first deadline to file for a Meaningful Use Hardship for the 2015 reporting year to avoid a 2017 penalty is March 15.  There are several changes to the hardship process including a new application, deadlines, and rationale for filing.  Wondering if you need to submit documentation to CMS?  Unclear how the rationale for the tardiness of the Modified Stage 2 rule affects the hardship filing process?  Wondering if you should apply? CHIME has the answers in our new fact sheet which also includes links to the newly published frequently asked questions (FAQs). 

Key Takeaway: CMS Acting Administrator Highlights IT and Rural Health in Recent Speech

Why it Matters:  The Centers for Medicare and Medicaid Services (CMS) Acting Administrator Andy Slavitt delivered a speech before the National Rural Health Association where he highlighted CMS accomplishments for 2015 and drew attention to the agency’s focus on rural health issues.  In his speech he made several comments of note concerning the direction the Agency is headed around health IT and interoperability including alluding to some efforts to better align what they are doing on the physician side with the hospital side as well.  Specifically, he noted:

This year, starting in the physician’s office, the bipartisan MACRA legislation offers us the opportunity to step back from Meaningful Use and to move towards a better system. We will be putting out details over the next several months, but there are several themes which inform our approach specific to technology.

  • First, the focus will move away from rewarding providers simply for the use of technology and towards the outcome they achieve with their patients.
  • Second, providers should be able to customize their own goals so tech companies can build around the individual practice needs, not the needs of the government. Technology must be user-centered and support physicians, not distract them.
  • Third, we need to aid this is by leveling the technology playing field for start-ups and new entrants. We are requiring open APIs so the physician desktop can be opened up, moving away from the lock that early EHR decisions placed on physician organizations to allow apps, analytic tools, and connected technologies to get data in and out of an EHR securely and adapt to the way physician’s want to work, not dictate it.

And finally, we are deadly serious about interoperability. We will begin initiatives in collaboration with physicians and consumers toward pointing technology to fill critical use cases like closing referral loops and engaging a patient in their care. And technology companies that look for ways to practice “data blocking” in opposition to new regulations will find that it won’t be tolerated.

As you know, the MACRA legislation applies to physician office care, not hospital incentives, but we will also be exploring vehicles to align hospital measurements with these principals as well. As we move forward, there will be critical opportunities to engage on the details and invite public comment. Our goal in communicating our principles now is to give everyone time to plan for what’s next and to continue to give us input, not take their foot of the gas on current initiatives.

On rural health, he had this to say:

In order to make sure we invest strategically, we are establishing a CMS Rural Health Council to work across the entire agency to oversee our work in three strategic priority areas– first, improving access to care to all Americans in rural settings; second, supporting the unique economics of providing health care in rural America; and third making sure the health care innovation agenda appropriately fits rural health care markets.

Key Takeaway: ONC Publishes Test Tools for Certified EHRs

Why it Matters:  In February 4th the Office of the National Coordinator (ONC) announced in the Federal Register the availability of their approved test tools for the testing of Health IT Modules to the 2015 Edition health IT certification criteria under the ONC Health IT Certification Program. The approved test tools and test procedures are identified on the ONC Web site.