MGMA asks lawmakers to offer laws to expand telehealth access

Telehealth offers the potential to increase access to care, but needs comprehensive legislation to accelerate its use more broadly in the country.

The Medical Group Management Association offered this conclusion in a letter it sent to 10 members of Congress serving on the Congressional Telehealth Caucus. The professional group, representing the nation’s group practices, wrote the letter in response to a request for information on how to use the technology to expand access to telehealth and improve patient outcomes.

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The professional organization notes that telehealth use among Medicare fee-for-service beneficiaries is low. “In 2016, only 0.25 percent of more than 35 million Medicare FFS beneficiaries used telehealth services,” wrote Anders Gilberg, senior vice president of government affairs at MGMA in the group’s letter of recommendations.

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Like the members of the Telehealth Caucus, MGMA believes there are opportunities to increase access to care by leveraging telehealth services.

MGMA calls for expanding telehealth coverage by redefining geographic restrictions. For example, the Social Security Act continues to prohibit Medicare reimbursement of telehealth services except when the eligible telehealth individual is located at a qualified “originating site,” such as a rural health professional shortage area, or a county not in a Metropolitan Statistical Area, or the organization participates in a federal telemedicine project.

Further, MGMA notes instances where hospitals or nursing facilities are located in health professional shortage areas, but because they are not in rural areas they don’t meet the requirements for telehealth services, leaving those populations without the ability to benefit from convenient telehealth treatment.

That said, there has been recent congressional progress on telehealth policy.

Congressional legislation removed geographic requirements for home dialysis for end-stage renal disease patients and telehealth treatment, effective this past January, and will remove the geographic requirements hindering substance abuse treatment effective in July.

MGMA wants geographic limitations to be further eliminated beyond existing limited scenarios. The organization strongly suggests that Section 1834(m) of the Social Security Act be amended to permit a telehealth-originating site to consist of either a rural or urban health professional shortage area.

“By making this small technical change to permit an originating site to be a non-rural health professional shortage area, Congress can expand telehealth access to beneficiaries who otherwise might go without medical attention in underserved areas, regardless of whether they reside in a rural setting,” Gilberg concludes.

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