ATA asks Medicare to remove restrictions on telemedicine

The American Telemedicine Association (ATA) has called on the Centers for Medicare and Medicaid Services (CMS) to use its authority to waive the restriction-riddled Medicare telemedicine statute for the new Accountable Care Organizations (ACOs).

In a letter addressed to Donald M. Berwick, M.D., Administrator of Centers for Medicare & Medicaid Services Department of Health and Human Services, the ATA applauded the "vision for Accountable Care Organizations (ACOs) as expressed both by Congress and CMS and supports the importance of incorporating modern technologies and telehealth," citing examples from Patient Protection and Affordable Care Act and President Obama's January State of the Union address.

"Unfortunately," the ATA wrote, "despite Congressional intent and the enthusiasm of the Agency, the proposed ACO regulations will not enable this vision because the ACOs will still be subject to formidable statutory restrictions for telehealth services under Medicare Parts A and B as authorized under Social Security Act section 1834(m). Congress expressly gives the HHS Secretary the authority to waive this restriction under section 1899(f) but unfortunately this was not included in the proposed rulemaking."

“ATA supports the vision of Accountable Care Organizations, but without providing them access to telemedicine, their promise will not be realized,” said ATA’s Chief Executive Officer, Jonathan Linkous, in a press release. “Given the ACO’s financial limits and incentives, hindering them with Medicare’s outdated restrictions on telemedicine will block the goal of efficiently delivering the care beneficiaries need and want.”

CMS has the power to waive Medicare statutory provisions “as may be necessary to carry out” the ACO provisions. In formal comments to CMS, ATA proposed five specific changes to Medicare, stating that the sections need to be waived "as they contain major, arbitrary barriers to Accountable Care Organizations." CMS asked that the final rules allow:

  1. Medical videoconferencing for the 35 million beneficiaries who live in metropolitan areas
  2. Store-and-forward of medical images for the 43 million beneficiaries who don’t live in Alaska or Hawaii
  3. Physicians to judge the appropriate ACO use of telemedicine for otherwise covered services
  4. Home-based medical videoconferencing
  5. Otherwise covered therapy services to be delivered via telehealth

ATA’s full comments are available at www.americantelemed.org/ACOComments.

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