The Centers for Medicare & Medicaid Services (CMS) has included a policy change to expand provider payments for telehealth services under the proposed 2014 Medicare Physician Fee Schedule. The proposed rule is schedule for publication in the Federal Register this Friday, July 19, 2013. Find specifics on proposed changes to telehealth services for Calendar Year (CY) 2014 fee schedule starting on page 163.
The proposed change to payments for telehealth services for CY 2014 includes:
1. Modifying the definition of a rural Health Professional Shortage Area, or HPSA, as determined by the Office of Rural Health Policy (ORHP). CMS states in the proposed change that redefining “rural” to include geographic areas within Metropolitan Statistical Areas (MSAs) would allow for “additional HPSAs as areas for telehealth originating sites”. The adoption of this more precise definition would expand healthcare services for Medicare beneficiaries. (See page 170 of the proposed rule).
2. Along with redefining the definition of an originating site, CMS is proposing that an originating site’s geographic eligibility be established on an annual basis, based on the status of the area as of December 31st of the prior calendar year. This change aligns with other telehealth services payment policies and would also avoid mid-year interruptions in service if an originating site’s location is re-classified (See page 171 of the proposed rule.)
Adding Services to the List of Medicare Telehealth Services
The proposed 2014 Physician Fee Schedule also includes proposed additions for the upcoming year, including several from the American Telemedicine Association (ATA). There is an established process for adding or removing Medicare telehealth services from an approved payment list, formalized in rule 76 FR 73102, published in the Federal Register on November 28, 2011. Proposed additions to CY 2014 can be found starting on page 173.
In the statement on ATA’s website on the proposed changes for CY 2014, CEO Jonathan Linkous says “Of course, this is just one small step in the right direction. For 15 years the federal government has placed strict restraints on the use of telehealth while employers, private payers, states and many other nations have moved boldly forward, improving the quality and reducing the cost of care. It is time to unleash the power of modern technology and allow Medicare beneficiaries, regardless of whether they live in a rural area, underserved inner-city, in a clinic or at home to be eligible to receive the benefits of telehealth.”
The proposed rule will be published in the Federal Register on July 19. Comments will be accepted until September 6, 2013 with the final rule expected November 1, 2013.
- To make a request to add or remove a telehealth service
- CMS Telehealth Fact Sheet
- American Bar Association’s analysis of the proposed rule
Category: Public Policy