New bill would expand beneficiaries’ access to telehealth

Senators reintroduce CHRONIC Care Act, which would provide more options for virtual services in treating Medicare patients who have persistent conditions, says Sen. Ron Wyden.

A bipartisan group of senators on Thursday reintroduced a bill seeking to improve health outcomes for Medicare beneficiaries living with chronic diseases by, among other provisions, expanding access to telehealth services.

The Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 was reintroduced by Senate Finance Committee Chairman Orrin Hatch (R-Utah) and Ranking Member Ron Wyden (D-Ore.), along with Senators Johnny Isakson (R-Ga.), and Mark Warner (D-Va.), co-chairs of the Finance Committee Chronic Care Working Group.

The bill (S. 870) contains major telehealth provisions targeted at patients with chronic conditions, including expanding the ability of home dialysis beneficiaries to receive required monthly clinical assessments using telehealth, beginning in 2019.

Section 102 “expands the number of originating sites from which the beneficiary can have a telehealth assessment with the nephrologist to include freestanding dialysis facilities and the patient’s home; and enables these telehealth visits to be conducted from the expanded list of sites without geographic restriction.”

Under Section 305 of the bill, patients presenting with stroke symptoms would also see expanded access to telehealth, receiving a “timely consultation to determine the best course of treatment” via telehealth, beginning in 2019.

“Specifically, it would eliminate the geographic restriction as to permit payment to a physician furnishing the telehealth consultation service in all areas of the country,” states the proposed legislation. “The hospital at which the patient is present and the telehealth consultation is initiated would not receive a separate originating site payment.”

Section 303 of the bill would also allow a Medicare Advantage plan to offer additional telehealth benefits in its annual bid amount beyond the services that currently receive payment under Part B, beginning in 2020.

“An MA plan may provide basic telehealth benefits as part of the standard benefit; for example, telemonitoring and web-based and phone technologies can be used to provide telehealth services,” states the bill. “Medicare Advantage Prescription Drug (MAPD) may choose to include telehealth services as part of their plan benefits, for instance, in providing medication therapy management (MTM). However, while there is nothing to preclude MA from providing telemedicine or other technologies that they believe promote efficiencies beyond what is covered in the traditional Medicare program, those services and technologies are not separately paid for by Medicare and plans must use their rebate dollars to pay for those services as a supplemental benefit.”

In addition, under Section 304, certain accountable care organizations would be given more flexibility to provide telehealth services.

Also See: Why Medicare needs to increase payments for telehealth

“Medicare policy cannot stand idly by while the needs of people in the program shift to managing multiple costly chronic diseases. This bill provides new options and tools for seniors and their doctors to coordinate care and makes it less burdensome to stay healthy,” said Wyden in a written statement.

Morgan Reed, executive director of the App Association’s Connected Health Initiative, applauded the senators’ decision to reintroduce the CHRONIC Care Act.

“We have long advocated the important role healthcare technologies can play in treating the most debilitating illnesses in the most vulnerable populations,” said Reed. “The reintroduction of this act is a step in the right direction to incorporate telehealth solutions into the treatment of chronic illness, specifically strokes, and help Medicare leverage the use of innovative technologies to improve patient outcomes and lower medical costs.”

At the same time, Reed noted that Congress “has more to do to bring the benefits of connected health technologies to more Americans, including improving the use of remote monitoring in community health centers and rural health clinics.”

A section-by-section summary of the CHRONIC Care Act is available here.

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