While telemedicine can improve access to care and reduce costs, new policies are needed to increase adoption by primary care providers, according to the American College of Physicians.
The organization has issued a position paper offering a dozen policy statements and recommendations for the practice and utilization of telemedicine in primary care, as well as reimbursement for those services.
“We think that telemedicine is a fantastic, innovative way to provide primary care or other care in certain situations and that will be embraced by physicians and patients in some communities,” says Wayne Riley, M.D., president of ACP. “Now, obviously, the caveats are that you have to be careful in the way that telemedicine is implemented in your particular area and there are lots of regulatory hoops to jump through because the extent of telemedicine is pretty much determined by state licensing laws. The regulatory overlay is very difficult to navigate.”
As a result, ACP supports a “streamlined process to obtaining several medical licenses that would facilitate the ability of physicians and other clinicians to provide telemedicine services across state lines while allowing states to retain individual licensing and regulatory authority.”
In Congress, Reps. Devin Nunes (R-Calif.) and Frank Pallone, Jr. (D-N.J.) have introduced the TELEmedicine for MEDicare (TELE-MED) Act of 2015 that would permit Medicare providers licensed to practice physically in one state to treat patients electronically across state lines. Under the TELE-MED Act, which ACP supports, a Medicare participating physician or practitioner would be able to provide services to a Medicare beneficiary across state lines without being licensed in that patient’s state as long as the provider is licensed or authorized to provide that service in their own state.
ACP also advocates for “appropriate” Medicare and Medicaid reimbursement policies and “reform in the way that CMS looks at telemedicine services,” according to Riley, who argues that if the two federal payers innovate in terms of paying for telemedicine, then commercial insurers will follow suit.
In particular, the physician group is in favor of “lifting geographic site restrictions that limit reimbursement of telemedicine and telehealth services by Medicare to those that originate outside of metropolitan statistical areas or for patients who live in or receive service in health professional shortage areas.”
Riley adds: “Whatever we can do to break down those kind of geographic barriers we think is a good thing.” Additionally, ACP supports “reimbursement for appropriately structured telemedicine communications, whether synchronous or asynchronous and whether solely text-based or supplemented with voice, video, or device feeds in public and private health plans, because this form of communication may be a clinically appropriate service similar to a face-to-face encounter.”
A summary of ACP’s position paper was published in the Annals of Internal Medicine and is available here.
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