iToday, a bipartisan group of Senators led by Senator Brian Schatz (D-HI) and Senator Roger Wicker (R-MS) have unveiled legislation that would expand the use of telemedicine and remote patient monitoring under Medicare. The CONNECT for Health Act (S.2484) is not seeking to overhaul telemedicine statutes overnight. Rather, it’s creating an opening for providers to incorporate telemedicine into their practices in a way that enables the federal government to further study and evaluate its application in health care delivery.
The CONNECT for Health Act would establish a program to help providers who would be subjected to new payment restrictions under the Medicare Access and CHIP Reauthorization Act (SGR-repeal) transition – through the use of telemedicine and remote patient monitoring services – into the new Merit-Based Incentive Payment System. Those providers who are eligible would be able to use telemedicine and remote patient monitoring services without the restrictions currently placed on telemedicine reimbursement in Medicare (42 U.S.C. 1834(m)).
This legislation would also allow stakeholders utilizing alternative payment models to use telemedicine and remote patient monitoring services, on the condition that it is budget-neutral and certain reporting requirements are met. It would also expand the use of these services for those with chronic conditions, a particular focus of the Senate Finance Committee this year, by allowing individuals with two or more covered chronic conditions that have a recent history of two or more hospitalizations in the preceding 12 months to be eligible for telemedicine services for 90 days, with a possibility for renewal.
Two interesting quick initial observations about the measure. First, this bipartisan measure has attracted a host of stakeholder support from across the spectrum – including from groups like the American Telemedicine Association and American Medical Association, which haven’t exactly seen eye-to-eye on previous efforts to address telemedicine-related issues.
Second observation is the “score” of the bill – or how much it would potentially cost to enact. According to the bill’s proponents, an analysis by Avalere of the bill’s major provisions (mentioned above) show $1.8 billion in savings over 10 years. If true, that’s a significant development. For years, telemedicine advocates have heaped praise on the potential cost savings associated with telemedicine through increasing access to care, whether it be through video conferencing or remote patient monitoring services.
While the Avalere score is optimistic, the legislation will have to undergo scrutiny from the Congressional Budget Office (CBO), which has consistently and steadfastly expressed skepticism that expanding the use of telemedicine would cut costs for Medicare, often citing the potential for increased utilization of services – and thereby increased costs to the taxpayer. However, last July, CBO indicated that the lack of extensive data hinders its efforts to understand how expanding coverage would affect federal spending in Medicare, and that “having more evidence about how the telemedicine coverage affects spending would thus be useful,” and that the results of a demonstration project could be particularly helpful.
