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CONNECT for Health Act gets provider, HIMSS support

The bill has bipartisan support to lift restrictions on Medicare coverage for telehealth.

Susan Morse, Senior Editor

HIMSS and the Personal Connected Health Alliance have added their support to a bill that would lift restrictions on Medicare coverage for telehealth.

The CONNECT for Health Act of 2019, introduced yesterday in the Senate, would grant authority for the Secretary of the Department of Health and Human Services to waive current telehealth restrictions in fee-for-service Medicare, including remote services in the home, according to David Gray, senior manager, Congressional Affairs and Connected Health Policy for HIMSS.

The bill has the support of numerous healthcare organizations, including the American Hospital Association, the American Medical Association, and the Health Information and Management Systems Society (HIMSS), the parent organization of Healthcare Finance News. It also has the support of HIMSS innovation company, the Personal Connected Health Alliance (PCHAlliance).

"Evidence-based telehealth can help improve access to high-quality care for many Medicare beneficiaries and address many accessibility issues that underserved areas and beneficiaries often face. In today's healthcare environment, outdated and overly burdensome restrictions on the use of telehealth and other healthcare technologies under Medicare continue to limit the potential and impact of these valuable tools and services for healthcare providers," said the letter by HIMSS President and CEO Hal Wolf and Steve Wretling, chief technology and innovation officer on behalf of the PCHAlliance.

WHY THIS MATTERS

Medicare currently doesn't cover telehealth services except for a small subset of the population in rural areas.

The Centers for Medicare and Medicaid Services last year gave Medicare Advantage plans more flexibility to cover telehealth.

The ability for Medicare to use telehealth would expand access to consumers, with the goal towards cost savings and quality care.

Clinical uses could include video conferencing, remote patient monitoring, the use of telecommunications tools to monitor high-risk patients at home and the transfer of medical data for analysis and care. 

Among its benefits, the CONNECT for Health Act would help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the merit-based incentive payment system (MIPS) through the use of telehealth and remote patient monitoring. It would allow telehealth and remote patient monitoring to be used for alternative payment models.

The bill gets to the core issues HIMSS and the Personal Connected Health Alliance are focusing on, said Thomas M. Leary, vice president of Government Relations for HIMSS.

"It's high time for Congress to give Medicare additional tools needed to bring greater access to telehealth services," Leary said. "We're very hopeful."

The House also has its own version of the bill. Both bills must get their respective approvals before being merged for the president's signature.

"One of the reasons I'm hopeful is every year we've seen growing support and in 2018, we saw two telehealth bills pass and saw CMS take action on care," Gray said. "We're looking to build on momentum on 2018."

THE LARGER TREND

This is the third itineration of the bill that was first introduced about four years ago, according to Gray.  Some sections have been adopted, such as four sections that were put into the Chronic Care Act, and also into the Bipartisan Budget Act of 2018.

At the end of each Congress, bills expire, which gives the CONNECT for Health Act for 2019 until the end of 2020 to pass. The bill has bipartisan support.

"Nothing in the bill is really controversial," Gray said.

The biggest reason the bill has not been passed into law is because of Congressional Budget Office scoring on federal spending that has shown telehealth would increase spending. The reasoning has been one of potential overutilization by patients who would both call their doctors and visit them in person.

The Congressional Telehealth Caucus has been a force behind a number of telehealth bills. In March, it requested stakeholder input to guide legislation to expand access to telehealth and remote monitoring services.

ON THE RECORD

"In today's healthcare environment, outdated and overly burdensome restrictions on the use of telehealth and other healthcare technologies under Medicare continue to limit the potential and impact of these valuable tools and services for healthcare providers," said the HIMSS October 30 letter sent to U.S. Senators. "The CONNECT for Health Act of 2019 will bring much needed changes to the Medicare program by removing many of these artificial barriers. Specifically, this legislation will expand access for mental health services through telehealth, remove arbitrary geographic and originating site limitations, support greater utilization of telehealth during national emergencies, and address other important aspects to expand access to quality healthcare."

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com