AMA Pushes Telemedicine Payment Guidelines

At its annual meeting, the American Medical Association approved a list of guiding principles for ensuring the “appropriate coverage of and payment for telemedicine services.”


At its annual meeting, the American Medical Association approved a list of guiding principles for ensuring the “appropriate coverage of and payment for telemedicine services.”

The principles are meant to foster innovation in the use of telemedicine, protect the patient-physician relationship and promote improved care coordination and communication with medical homes, according to the association. Currently, due to restrictions in section 1834(m) of the Social Security Act, there is no coverage for services originating from a beneficiary’s home (even for the “homebound”), a hospice and other common non?medical locations from which a beneficiary seeks service.

"We believe that a patient-physician relationship must be established to ensure proper diagnoses and appropriate follow up care," said new AMA President Robert M. Wah, M.D. "Telemedicine can strengthen the patient-physician relationship and improve access for patients to receive health care services remotely as medically appropriate including care for chronic conditions, which are proven ways to improve health outcomes and reduce healthcare costs."

The AMA’s action comes just days after 12 companies and organizations sent a letter to new Health and Human Services Secretary Sylvia Mathews Burwell encouraging her to use existing authority to waive the current restrictions in the Social Security Act for telemedicine and remote patient monitoring services in the Medicare Shared Savings Program (MSSP). They also urged her to request comment on the use of telemedicine and remote monitoring by accountable care organizations in a forthcoming proposed rule for the MSSP.

“While current areas of focus, particularly on the agency level, remain on electronic health records and EHR interoperability, there is a true need for federal priorities to address the full potential of the health information technology ecosystem which is comprised of many technologies, including telehealth and medical remote monitoring,” states the June 9 letter, signed by the American Telemedicine Association, Association of Clinicians for the Underserved, Health IT Now Coalition, HIMSS and the Telecommunications Industry Association, among others.

The organizations contend that an outdated legal and regulatory structure is limiting the potential of telemedicine and remote patient monitoring to reduce inpatient care and readmissions, as well as improve care coordination. “We respectfully urge you to use your existing authority to waive the current restrictions in section 1834(m) of the Social Security Act on Medicare reimbursements of connected care services for ACO MSSP provider participants,” they request in the letter to Burwell.

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