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Congress Considers Expanding Telehealth Accessibility for Medicare Clients

By  Senior Market Advisors  on March 21, 2016

Congress Considers Expanding Telehealth Accessibility for Medicare Clients

Congress is reviewing ways Medicare beneficiaries with chronic conditions may become eligible for expanded Telehealth accessibility.  Consequently, an expansion of these services could improve health care, reduce costs, and create better care coordination.

In sum, the Centers for Medicare & Medicaid Services (CMS) has always offered little coverage for telehealth services. For coverage, patients must be seen at an approved “originating site,” by an approved provider, and for a small defined set of services. Now, Congress is looking into expanding these services in a few areas.

Expanded Access to Home Dialysis Therapy  

Today, Medicare beneficiaries can only receive home dialysis coverage if they meet certain requirements. The new law would lift geographic restrictions on Medicare reimbursement, allowing for more home treatments.

Medicare Advantage Changes

Currently, Medicare does not cover telehealth services. This proposal would allow Medicare Advantage plans to pay for the use of telehealth services. It applies if they are included as part of the bid process and they act as an expansion of supplemental benefits.

Providing ACOs the Ability to Expand Telehealth Use

Another piece of this legislation would waive the geographic limits of Accountable Care Organizations and redefine what the “originating site” is.  This would also apply to the Telestroke programs in rural areas.

It will also allow caregivers more geographic freedom. As a result, more in-home health assessments will become available. 

2017 Update

Congress has been reconsidering a bill called the “Medicare Telehealth Parity Act of 2017” to modernize Medicare. The first phase would expand qualified sites to include rural areas. Additionally, it would cover certified audiologists, occupational therapists, speech-language therapists, and physical therapists as well as diabetes specialists and educators.

The second phase would expand the geographic network. Also, it would create a main web page for the program. The third phase would expand the network even further and authorize CMS to create payment methods for Medicare telehealth.

This page is updated to reflect August 2017 news.