AHA calls for more global approach to coverage in House Medicare telehealth proposal

Legislation to revamp Medicare’s telehealth legislation should address several statutory restrictions that stand in the way of modernizing coverage and payment for telehealth services, the AHA last week told a congressional working group that recently circulated a draft proposal. 

In a Jan. 26 letter to the working group, the AHA called the House Energy and Commerce Committee members’ draft legislation “a step in the right direction,” and applauded the lawmakers for taking on the issue.

The draft was provided by eight members of the committee, led by panel Chairman Fred Upton, R-Mich. and ranking member Frank Pallone, D-NJ.

“The AHA strongly agrees with your goal of expanding coverage of telehealth services in Medicare, and appreciates the specification of a mechanism for doing so,” AHA Executive Vice President Rick Pollack wrote. “However, given the growing body of evidence that telehealth increases quality, improves patient satisfaction and reduces costs, we believe a more global approach to expanding Medicare coverage of telehealth is warranted.”

Pollack noted that the AHA recently released an AHA TrendWatch report on the promise of telehealth to improve patient care. The report found that more than half of hospitals used telehealth in 2013, and another 10% were on their way. For more on the January report, visit the Research & Trends section of www.aha.org.  

But the report and letter said that Medicare is lagging behind the private sector and many state Medicaid programs in promoting telehealth. “In order to modernize Medicare coverage and payment for telehealth, several statutory restrictions must be addressed,” the AHA stated.

The AHA’s comments refer to the “Advancing Telehealth Opportunities in Medicare” proposal. The working group’s discussion draft calls for the Department of Health and Human Services (HHS) to create a methodology that would expand coverage and payment for telehealth services. But it would only apply if HHS finds that the services would not increase costs to the program.

Medicare’s current “service-by-service consideration for telehealth … has proven to be a cumbersome approach that results in limited coverage,” Pollack wrote. He also said that removing geographic restrictions only for certain services would create serious operational challenges.

“For example, it would be very challenging to establish a telehealth program to address access problems in the inner city if only certain services are covered,” the letter stated.

The association also faulted the proposal for failing to address technology limitations in the Medicare program or payment for remote monitoring.

For more on the letter, click here.