CMS Encourages Telehealth Use
Although this article “sounds” encouraging from it’s title, CMS has a loooooong way to go:
When the Centers for Medicare and Medicaid Services (CMS) announced in early May 2011 that is was streamlining the telemedicine physician-credentialing process, advocates for telehealth couldn’t have been happier. The new rules, which become effective in August 2011, will make it easier for hospitals to use telehealth services like video conferencing to connect rural patients with specialists based in metropolitan areas.
The old telehealth rules require that physicians and practitioners who have credentials at metropolitan hospitals must go through a second credentialing process at small rural hospitals where they offer telehealth services. This second credentialing process is required even though the telehealth physicians do not work onsite at the rural hospitals and do not need hospital privileges.
CMS says the credentialing change is expected to help more patients receive telemedicine services in a timely manner. Advocates agree, but question why a separate set of rules governing the establishment of Accountable Care Organizations (ACO), don’t increase CMS reimbursement for telehealth services.
The Affordable Care Act authorized the establishment of ACOs, which are defined as groups of health care providers that work together to coordinate care and reduce the costs of treating certain Medicare beneficiaries. While the health-reform legislation urges ACOs to use telehealth, remote monitoring and other enabling technologies to carry out their work, critics were disappointed that regulations released by CMS this spring did not expand coverage for the use of telehealth services.
In particular, the American Telemedicine Association (ATA) opposes ACO rules that allow coverage of videoconferencing services only for patients in rural communities and do not extend current fee-for-service coverage for telehealth services if they originate from a patient’s home, hospice or dialysis center. According to InformationWeek magazine, the ATA is also concerned that the rules don’t broaden coverage of telehealth services to include occupational, physical, speech and other therapies, and diabetes self-management training, hospital discharge services, medical nutrition therapy or neuropsychological testing.
“The ACO model is an important opportunity to make Medicare health care delivery more innovative and higher performing,” says the ATA. “Telehealth is a key set of tools that has been widely acknowledged as an integral part of helping ACOs make a difference.”
Nevertheless, CAST believes that the prospect of shared savings should encourage providers to use these technologies in services that are not currently reimbursable under fee-for-service.