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The Proposed Medicare Telehealth Parity Act of 2015 Would Expand Medicare Reimbursement for Telehealth Services

Although telemedicine has made many technological advancements in the past decade, it still faces several legal and financial barriers to widespread use and acceptance.  Chief among these are poor reimbursement policies; according to the American Telemedicine Association, 29 states earned an “F” for coverage and reimbursement standards.  States have attempted to rectify some of these payment barriers with state telehealth parity acts, which require that telehealth visits be reimbursed at the same rate as in-person visits.  On July 7th, Deleware became the 29th State to enact telehealth parity laws.

 

Congress is now considering a nation-wide telehealth parity act.  Representative Mike Thompson (D-CA) has sponsored the Medicare Telehealth Parity Act of 2015 in the House, along with co-sponsors Representatives Gregg Harper (R-MS), Diane Black (R-TN), and Peter Welch (D-VT).  The Act  is intended to modernize the way Medicare reimburses telehealth services and to expand coverage for Medicare beneficiaries.  

The bill’s expansion of telehealth coverage and reimbursement would be implemented in three phases over a four year period.  By the end of the third phase, the act would expand telehealth coverage to include all federally qualified health centers and rural health clinics, and would expand qualifying geographic locations to include counties in Metropolitan Statistical Areas with populations over 100,000.

The bill would also expand coverage of telehealth services, to include services provided by certified diabetes educators, respiratory therapists, audiologists, occupational therapists, speech language therapists, and physical therapists.  Medicare coverage would also be available across the country for asynchronous telehealth services, where communications are conducted via a store-and-forward system, rather than in real time.

This bill is the next step in Congress’s continued effort to expand Medicare telehealth reimbursement.  Similar legislation was introduced by Representative Thompson in 2013 (the Telehealth Enhancement Act of 2013), and again last year (the Medicare Health Parity Act of 2014).  Neither of those bills have made it out of Committee, despite strong industry support.

© 2020 Covington & Burling LLPNational Law Review, Volume V, Number 217

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About this Author

Shruti Barker, Covington Burling, Healthcare attorney
Associate

Shruti Barker is an associate in the firm’s Washington, DC office, where she practices in the areas of health care, federal-state programs, and employee benefits. Ms. Barker advises state agencies, providers, food manufacturers, and other clients on issues related to government-sponsored health care programs. Ms. Barker has experience with an array of healthcare statutes and regulations, including Medicare, Medicaid, Women, Infants, and Children (“WIC”), and the Supplemental Nutrition Assistance Program.

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