2015-2016 Congressional Asks: Expand Access to Telehealth Services for Medicare Beneficiaries

Telehealth services, and the technology that supports them, can expand access to higher quality care for underserved communities (both urban and rural), address provider shortages, facilitate proactive disease prevention and chronic care management, and improve patient and provider satisfaction.  Quixotically, current law prevents CMS from reimbursing most providers and health systems for telehealth services and remote patient monitoring. 

HIMSS urges Congress to amend current law, and take steps to require CMS to remove barriers to deployment, and encourage broader types of technologies that will improve access and quality, and reduce cost. 

Specifically, Congress should:

  1. Amend the allowable originating sites of care beyond those currently stipulated by CMS to include interactions with patients from wherever the patient is located, including the home, where cost-effective and clinically-appropriate.
  2. Eliminate the geographic restrictions on telehealth (i.e., currently not allowed in metropolitan statistical areas.  Currently open only to Health Professional Shortage Areas).
  3. Allow expanded use of “store and forward capability” to aid long-term passive monitoring of chronic diseases (i.e., currently, only Alaska and Hawaii may use for federal demonstration projects).
  4. Expand modalities beyond live (real-time) voice and video to active monitoring between clinicians, patients and care providers (i.e., Asynchronous vs. Synchronous).
  5. Update Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) to cover in-home monitoring or clinician/patient non-centralized exchanges, including shared decision making.
  6. Encourage nationwide efforts to harmonize federal and state efforts to address the challenges of licensing clinicians to serve patients across traditional state boundaries.