ACOs Join Calls for Relaxed Restrictions on Telehealth Reimbursements

Telemedicine-focused industry groups and a coalition of accountable care organizations have written a series of letters to new HHS Secretary Sylvia Mathews Burwell urging her to use her authority to waive restrictions that inhibit the use of telemedicine in accountable care and shared savings programs.

In one letter, the Alliance for Connected Care, an advocacy group led by former Senate Majority Leaders Tom Daschle and Trent Lott and former Sen. John Breaux, outlines the current reimbursement rules that are restricting the use of telemedicine in the Medicare Shared Savings Program. These restrictions include:

  • No reimbursement for "store-and-forward" telemedicine unless the beneficiary lives in Hawaii or Alaska
  • No reimbursement for telemedicine services delivered in a beneficiary's home
  • No reimbursement for physical therapy, occupational therapy and additional otherwise-covered services if rendered via telemedicine
  • No reimbursement for more health procedure codes

One of the most prohibitive rules, however, is the one restricting reimbursement to telemedicine services originating in a rural setting. According to the ACC, just 20 percent of Medicare beneficiaries live in rural areas, meaning providers have little incentive to provide telemedicine services to a vast majority of the Medicare population.

A letter signed by leaders from 29 health systems and accountable care organizations whose organizations all participate in the Medicare Shared Savings Program shows their belief that waiving this restriction would foster the use of telemedicine among their affiliated physicians and not force the health systems or ACOs to assume the cost of desired telemedicine services.

"Allowing ACOs to be reimbursed for connected care will further the goals of the MSSP by providing us with additional tools to improve quality and reduce costs," according to the letter. "Furthermore, it is consistent with the language of the [Patient Protection and Affordable Care Act], which required ACOs participating in the MSSP to 'define processes…to coordinate care, such as through the use of telehealth, remote patient monitoring and other such enabling technologies.'"

More Articles on Telemedicine:

How Telemedicine May Increase Specialty Care Visits
Atlantic General Hospital, Kennedy Krieger Institute Partner for Telemedicine
King's Daughters Medical Center, St. Dominic Hospital Partner to Offer Telemedicine Services

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars