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This Month in Telemedicine

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American Telemedicine Association’s policy duo Jonathan Linkous, CEO and Gary Capistrant, Senior Director of Public Policy, return with updates and new information regarding telemedicine.

What’s New With ATA

  • ATA Fall Forum– Sept 7-9 2014 JW Marriot Desert Springs Resort
  • First ATA meeting in China – October 28-30 2014
    *more information can be found on the ATA website
  • Learning Center – New! Online course was added; delivering online video based mental health services.
  • Series of Guidelines for ATA – Two guidelines have been made available by ATA through a free download on their website: “Core Operational Guidelines for Telehealth Services Involving Provider-Patient Interactions” and “Guidelines for TeleICU Operations” Both of these guidelines have been in process for months and have been reviewed and some are even officially used by certain medical societies.

 

Policy Items
American Medical Association issued a policy that was approved, however ATA has some concerns about it. AMA passed a long resolution (Report 7 of the Council of Medical Services) that was strongly worded and supported the idea of telemedicine and stated telemedicine services should be covered and paid. Some standards are required including a valid doctor patient relationship, it must abide by state licensure laws and medical practice laws, patient must have a choice of provider of medical services and the provider must be licensed in the state the patient is located. This last standard is a major concern for ATA as it impedes state licensure policies supported by ATA.

ATA as well as other organizations have made it a priority to try to get Accountable Care Organizations and Medicare to have the same flexibility to use Telehealth as a Medicare managed plan. It is actually a very simple process, all it requires is trying to get HHS to waive the rules and allow Accountable Care Organizations to provide telemedicine wherever it is needed. HHS can waive these rules at any time, as it is not a legislative issue.

Congress
House Congressional Committee – Energy and Commerce Committee has taken the lead on putting together an agenda for Telehealth and public comments have been submitted, including some from ATA. This committee has a unique jurisdiction within Congress; they have the most holistic jurisdiction dealing with Telehealth, not only for Medicare and Medicaid, but the public health service programs of health and human services and the federal communications commission. They can bring together all aspects of it, for example one of the platforms we’ve been looking at is for federally qualified health centers.

Congress has to act by the end of March on a “doc fix”, which is a way of fixing how Medicare pays for physicians. Another bill, HR 3077 will be moved through Congress along with Congressman Harper’s bill HR 3306. HR 3077 states that a physician needs to be licensed in one state in other to provide help for beneficiaries outside the state the health profession is licensed. All bills have been bipartisan. Congressman Mike Thompson of California has dealt with major Telehealth bills in the past, and there will be a proposal for him that would focus on incremental changes particularly for the Medicare program that will be introduced sometime in July.

Host Small Business Committee – A Congressional hearing will be held focusing for small providers/practitioners, July 31st. Any small providers or solo practitioners can contact ATA’s Senior Director of Public Policy, Gary Capistrant, to see what opportunities are available to be involved in the hearing.

Last Friday FDA proposed to remove the requirements for 510K process for medical device data systems and communication and storage devices for medical images. Proposed to down classify, now they’re proposing to completely remove the enforcement of the devices and says they are low risk. Link to the document will be posted on the HUB for public comment for the next 60 days.

State Level
Tennessee has enacted legislation for private insurance for Medicaid and state employee benefits. 36 states had some type of telehealth legislation, and many improved Medicaid coverage plans and administrative actions (8 states have recently amended Medicaid coverage to improve the coverage of Telehealth).


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