Group Asks Sebelius to Lift Telemedicine Restrictions

The American Telemedicine Association has asked the Department of Health and Human Services to "lift unnecessary restrictions on health care delivery that prohibits millions of Americans from accessing quality medical care."


The American Telemedicine Association has asked the Department of Health and Human Services to "lift unnecessary restrictions on health care delivery that prohibits millions of Americans from accessing quality medical care."

In a March 4 letter to HHS Secretary Kathleen Sebelius, ATA urged her to allow Medicare providers paid under alternative payment methods the flexibility to use telehealth as a means to add value for Medicare and its beneficiaries.

“Due to current restrictions outlined in the telehealth provisions of the Medicare statute 1835(m), providers cannot take advantage of the full capabilities of telemedicine and telehealth due to unnecessary limitations,” wrote Jonathan Linkous, chief executive officer of ATA. “The current language creates artificial barriers to care including patient location restrictions, communications technology restrictions, and it also defines a narrow list of eligible providers and covered services.”

In the letter to HHS, ATA made two recommendations:

HHS and CMS should waive the Medicare restrictions on telehealth in section 1834(m) for ACOs and Center for Medicare and Medicaid Innovation payment models for bundled acute care and medical homes

The agencies should also waive section 1895(e)(1) for these alternative payment methods to allow home telehealth and remote monitoring for “homebound,” Medicare beneficiaries

ATA's letter to HHS this week follows similar recommendations made last week to CMS Administrator Marilyn Tavenner regarding a specific payment innovation - the Pioneer accountable care organizations. According to ATA, the Affordable Care Act created a "number of value-based alternative payment models to fee-for-service reimbursement under Medicare in order to improve care coordination and reduce costs," yet ACOs, medical homes, and bundled payments, "have not been able to benefit from gains attributed to using telehealth."

As examples, ATA argued that these missed benefits include: a reduction of in-person hospital overuse, such as in emergency rooms and preventable inpatient admissions; relieving provider shortages; improving patient outcomes and quality; and supporting care coordination and population health.

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