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More Federal Legislation Aimed at Expanding Medicare Coverage of Telehealth Services

Late last month, Senator Cory Gardner (R-CO) and Senator Gary Peters (D-MI) introduced Senate Bill 787, the Telehealth Innovation and Improvement Act (Telehealth Improvement Act), which is focused on expanding Medicare’s currently limited coverage of telehealth services and opportunities for innovation.

The Telehealth Improvement Act would require the Center for Medicare and Medicaid Innovation (CMMI) to test the effect of including telehealth services in Medicare health care delivery reform models. More specifically, the Act would require CMMI to assess telehealth models for effectiveness, cost and quality improvement, and if the telehealth model meets these criteria, then the model will be covered through the Medicare program.

The Telehealth Improvement Act was originally introduced by Senators Gardner and Peters during the 114 Congress (S. 2343) in 2015, but the legislation failed to pass out of the Senate, and is now being reintroduced with hopes of greater support. The Senators emphasized that expanded reimbursement for telehealth care will benefit citizens of urban and rural communities, and the legislation could help “reduce costly emergency room visits, hospitalizations and readmissions” and “incentivize the healthcare industry to develop new technologies that could potentially reduce costs and improve patient health.”

In addition to the Telehealth Improvement Act, the Furthering Access to Stroke Telemedicine Act (Fast Act) was introduced earlier this year in both chambers. The Fast Act is focused on the expansion of access to tele-stroke care and has drawn bipartisan support.

Both the Telehealth Improvement Act and the Fast Act follow the 21st Century Cures Act (Cures Act), which was passed late last year and specifically called out telehealth as a potential means of delivering safe, effective, quality health care services to Medicare beneficiaries. Congress included a “sense” statement that communicates its desire for the development of a telehealth coverage expansion plan that contemplates the delivery of clinically appropriate types of services to Medicare beneficiaries. The Cures Act requires Centers for Medicare and Medicaid (CMS) and the Medicare Payment Advisory Commission (MedPAC) to report to the committees of jurisdiction in the House and Senate on the current and potential uses of telehealth in the Medicare program to assist Congress in its ongoing assessment of Medicare coverage of telehealth services.

In light of this increased legislative activity and the change in administration, health care providers and telehealth technology companies should:

  • Continue exploring ways to tailor their care delivery and revenue models to provide telehealth services to this large (and growing) segment of the population.

  • Consider developing or participating in studies designed to test the efficacy and efficiency of telemedicine programs.

  • Consider engaging with CMS and MedPAC on the issues in order to provide the federal government agencies charged with this investigation the best available industry information.

  • Focus operational goals to achieve cost and value goals that are of concern to the government.

© 2017 McDermott Will & Emery

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About this Author

Lisa Schmitz Mazur, Health Law Attorney, McDermott Will Law Firm
Partner

Lisa Schmitz Mazur is a partner in the law firm of McDermott Will & Emery LLP and is based in the Firm’s Chicago office.  Lisa maintains a general health industry practice, focusing on the representation of hospitals and health systems and other health industry providers.

Lisa’s representation of hospitals and health systems includes providing guidance on not-for-profit corporate governance matters, tax-exemption issues, conflict of interest compliance and overall corporate compliance effectiveness.  In addition, Lisa regularly assists hospital and health system clients to...

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Dale Van Demark, health care, attorney, McDermott Will, law firm
Partner

Dale C. Van Demark is a partner in the law firm of McDermott Will & Emery LLP and is based in the Firm’s Washington, D.C., office.  He focuses his practice on a broad array of merger, acquisition, investment, and strategic structuring transactions, with clients in the health industry. He has extensive experience in health system affiliation and restructuring transactions and regularly represents for-profit and tax-exempt clients in a variety of transactions, including strategic transactions with physicians and hospitals. He regularly advises clients regarding the opportunities and challenges that exist as the result of the passage of the Patient Protection and Affordable Care Act (PPACA) and the continuing trend toward greater collaboration among providers, including hospitals, community health centers and physicians.

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Associate

Shelby Buettner is an associate in the law firm of McDermott Will & Emery and is based in the Firm’s Chicago office. She focuses her practice on general health law matters.

Shelby previously coordinated clinical trials at an academic medical center, managed biomedical development projects with the Department of Defense and National Aeronautics and Space Administration, and conducted research with the United Nations Environmental Programme. She has been published in American Journal of Surgery, Journal of Robotic Surgery, Urologic Clinics...

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Associate

Marshall E. Jackson, Jr. is an associate in the law firm of McDermott Will & Emery LLP and is based in the Firm’s Washington, D.C. office.  Marshall focuses his practice on transactional and corporate matters affecting health care organizations,  including business organization, corporate governance, mergers and acquisitions, strategic affiliations and joint ventures.  Marshall also provides advice and counsel on a full range of federal and state fraud and abuse laws to hospital systems, medical practice groups and pharmacies.

Prior to...

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