Telemedicine bill lists heart failure for expanded coverage

A proposed bipartisan bill would expand the use of telemedicine and provide reimbursement for remote management of Medicare patients with congestive heart failure and other chronic conditions.

U.S. Reps. Mike Thompson (D-Calif.) and Glenn Thompson (R-Penn.) are floating a draft bill, the Medicare Parity Act of 2014, that would expand the range for reimbursable telemedicine services to eventually cover a broad swath of Medicare beneficiaries. The draft bill also calls for billing guidelines for remote patient management and a study on its effectiveness.

Patients who live outside metropolitan statistical areas who receive telemedicine services are now eligible for Medicare coverage. The bill would expand eligibility to patients within a metropolitan statistical area with a population of less than 50,000 people for services provided six months after the legislation was enacted. Two years after enactment, it would apply to patients in metropolitan statistical areas with a population of between 50,000 and 100,000; at four years, the program covers any site in a county within a metropolitan statistical area with at least 100,000 people.     

The draft defines remote patient management services as “remote monitoring, evaluation, and management of an individual with a covered chronic health condition.” Those conditions include congestive heart failure, chronic obstructive pulmonary disease and diabetes when diabetes services occur at a federally qualified health center.

The bill specifies that physicians and suppliers have the opportunity to weigh in on guidelines to determine the frequency of billing for remote patient management services and discusses budgetary issues. It also requires a study and report by the Government Accountability Office on the effectiveness of remote patient monitoring, its impact on reducing hospital readmissions, cost savings and its potential use for other chronic conditions.