In its comments to the Congressional Telehealth Workgroup, the American Telemedicine Association expressed concern for the bill's success.
CMS has been less than inclusive to the telemedicine community in the past, said Jonathan D. Linkous, CEO of ATA, in the Jan. 26 letter. Additionally, unless more careful measures are taken, telehealth could be seen as an unnecessary expense and shelved, he wrote.
"On numerous occasions CMS has refused to budge when given bipartisan directives from Congress," Mr. Linkous said. "The reality is that almost every improvement in Medicare coverage of telehealth has only been after Congress has enacted change, over the objections of CMS."
For example, one requirement currently prohibits bills from increasing Medicare spending. While this makes political sense, the reality is that spending usually increases during the implementation period, lasting about 12 months. The ATA suggested extending the no-budget impact period from one year to between two and three years.
The ATA also submitted 13 specific suggestions:
∙ Allowing the use of ACOs and bundled episodic payments to be exempt from Social Security Medicare limitations
∙ Allowing physicians to use telehealth networks for high-risk pregnancies and births
∙ Allowing the use of telehealth methods for timely diagnoses of strokes
∙ Allowing the use of telehealth services for at-home kidney dialysis
∙ Allowing the use of remote monitoring for congestive heart failure/chronic obstructive pulmonary disease
∙ Allowing the use of telehealth methods to work with rural federally qualified medical centers
∙ Allowing the use of current procedural terminology codes for telehealth coverage of neuropsychological testing, hospital discharge services, critical care and evaluation, nursing facility discharge services and other nursing facility services
∙ Allowing the use of relative value units for online assessment and management
∙ Allowing telehealth Medicare recertifications to fix the paradox of patients having to visit clinics to prove that they are homebound in order to qualify for Medicaid
∙ Allowing reciprocal state medical board compacts, so federal agencies do not have to pay for more than one for their employees
∙ Allowing the consolidation of funding for four grant programs through the Health Resources and Services Administration Office for the Advancement of Telehealth
∙ Allowing the creation of additional Autism CARES Act networks
∙ Allowing the inclusion of ambulance and emergency vehicle providers, health clinics at educational institutions and any other Medicare or Medicaid telehealth facilities under the Federal Communications Commission’s Universal Service Support clause