Telehealth Advocates Push for Flexibility, Better Medicare Reimbursement

With telehealth services set to become a force in healthcare, stakeholders in the burgeoning market are pushing lawmakers and healthcare groups to set some ground rules and formalize reimbursement processes.

In testimony before the US House of Representatives on May 1, telehealth industry professionals pointed out that language regarding telehealth in the Social Security Act has not been updated since 2000. According to those regulations, now 14 years old, individuals wishing to undergo a telehealth or video consultation must live in a rural setting and can only do so by driving to a clinic, iHealth Beat reported.

Telehealth advocates say this policy ignores those living in urban settings who also lack access to transportation, and thus telehealth services. Additionally, they argue that Medicare reimbursement for such services falls short, based on these outdated guidelines.

According to iHealth Beat, these advocates, including Rashid Bashshur, executive director for eHealth at the University of Michigan Health System, and Kofi Jones, vice president of public affairs for American Well, pushed Congress to expand Medicare reimbursement for telehealth regardless of:

  • A patient’s geographic location
  • The services provided
  • The real-time nature of the service


State Medical Boards Issue Their Own Guidelines

In late April, the Federation of State Medical Boards approved a model telehealth policy that critics say overemphasizes video technologies over telephone consults.

The guidelines stipulate that before a physician and a patient can enter into a telehealth scenario, physician-patient relationships can be created “whether or not there has been an encounter in person between the physician (or other appropriately supervised healthcare practitioner) and patient.”

As defined by the new policy, telemedicine “typically involves the application of secure video conferencing or store-and-forward technology to provide or support healthcare delivery by replicating the interaction of a traditional encounter in person between a provider and a patient.”

Critics of the policy charge that the guidelines would limit services only to people who have the proper devices and Internet speed and capabilities that allow video conferencing to work.

Dr. Henry DePhillips, chief medical officer of Teladoc, told Modern Healthcare that even patients in urban settings “over 95% of the time, will chose the telephone, even if they have the device and the bandwidth.”

The FSMB adopted its policy in April, despite protests from opponents.


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