Your Help Needed on Medicare Telehealth

One, or both, of your U.S. Senators are on the Finance Committee which tomorrow morning will vote on two important amendments to improve Medicare coverage for telehealth services. The amendments are part of the Finance Committee’s “mark-up” on Medicare physician payment reform.
Please email your Senator’s key staff TODAY urging their positive vote for these amendments. A full list of Finance Committee members by state, and their key staff, is below. If you know another staff person with the Senator, please also include them in your email.

1. One amendment will free Accountable Care Organizations (ACOs), bundled payments for acute hospital and post-acute care, medical homes and other alternative payment systems from the Medicare telehealth restrictions contained in Social Security Act, section 1834(m). These restrictions include:

  • No coverage in metropolitan areas (where 80% of Medicare beneficiaries live)
  • No coverage for “store-and-forward” (asynchronous) services
  • No coverage for services to beneficiaries at home or outside of a health establishment
  • No coverage for many providers otherwise covered for Medicare services, such as the therapies (notably, physical, occupational, speech-language-hearing)
  • No coverage for remote patient monitoring
  • Coverage restricted by specific CPT/HCPCS codes

This amendment is expected to be offered by Sens. Thune, Wyden, Roberts, Rockefeller, Enzi, and Stabenow. It is known as Thune #5.

2. The other amendment supports a Medicare demonstration program on remote patient monitoring. This amendment will be moved by Sens. Thune, Casey, Enzi. It is known as Thune #2.




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