US Rep. Doris Matsui (D-Calif) has been on a roll lately, having recently introducing a bill that would expand meaningful use – like payments to behavioral health providers, has also introduced a new bill, along with US Rep. Bill Johnson (R-Ohio), to reduce long-standing restrictions on Medicare's coverage of telehealth services.
The bill is one of a series. This specific one, the Evidence-based Telehealth Expansion Act of 2017, is designed to allow the secretary of Health and Human Services (HHS) to review Medicare-covered services to determine which are appropriate for telehealth and to waive existing restrictions on those services. The HHS secretary would have to ensure that the services delivered remotely would either reduce federal spending while maintaining quality or improve quality without increasing costs.
Likewise, the bill would mean that HHS Secretary Tom Price, MD, could waive those related to originating sites, geographic locations, the use of store-and-forward technologies, the types of providers who might supply telehealth services, and limitations on the payment codes designated as services that could be provided via telehealth. The secretary would determine which are appropriate for telehealth, and waive existing restrictions on those services. The secretary would ensure that the service delivered via telehealth would either reduce spending while maintaining quality or improve quality without increasing costs.
Specifically, the bill says that “in the case of telehealth services furnished on or after Jan. 1, 2018, the secretary may waive any restriction applicable to the coverage of telehealth services under … with respect to certain providers of services, suppliers, provider groups, sites of care, services, conditions, individuals receiving the services, or states, as determined by the secretary.”
Additionally, besides the HHS secretary, the chief actuary of the Centers for Medicare & Medicaid Services (CMS) would have to certify that the telehealth waiver would reduce or would not result in any increase in Medicare program spending.
The bill is an attempt to fill in some gaps of the stalled CONNECT for Health Act of 2017 – a longer and more complicated bill that actually enjoyed strong support from the healthcare industry. The estimated savings of the latter’s legislation would have potentially saved $1.8 billion over 10 years for the federal government.
The Matsui bill has not been evaluated for a potential financial savings.
Medscape reports that regard to geographic locations, “the bill notes that state licensure requirements would still apply. Twenty-two states have entered the Interstate Medical Licensure Compact, which facilitates the licensure of physicians in states where they don't reside. That compact is expected to support the growth of telehealth.”
In a statement, Matsui said: “We need to harness the power of technology to get care to people efficiently and empower them to manage their chronic conditions. This legislation helps ensure that we’re integrating telehealth into the healthcare system in a cost-effective and patient-centered way. I’m pleased to work with Congressman Johnson on this legislation as part of our overall efforts to expand access to telemedicine.”
Likewise, Johnson said, “This legislation would expand access to greatly needed telehealth services. The bill Congresswoman Matsui and I have introduced aims to increase telehealth services through Medicare by removing some of the arbitrary barriers to access currently in place. Increasing access to telehealth isn’t a partisan issue; rather, it’s a service that has proven to be very beneficial to many rural Americans – and it should be expanded.”