in response to the Bipartisan CHRONIC Care Working Group Policy Options Document released in December of 2015, the Senate Finance Committee recently introduced a draft of bipartisan legislation known as the Creating High-Quality Results and Outcomes necessary to Improve CHRONIC Care Act of 2016 (the CHRONIC Care Act). The CHRONIC Care Act seeks to modernize Medicare payment policies to improve the management and treatment of chronic diseases using telehealth.
Below is a summary of the key telehealth provisions under the CHRONIC Care Act that aim to expand access to home dialysis therapy and timely stroke care, increase convenience for Medical Advantage enrollees, and improve care coordination by accountable care organizations (ACO).
Expanding Access to Home Dialysis
Increasing Convenience for Medicare Advantage Enrollees through Telehealth
Medicare pays for a limited number of Part B services furnished by a physician or practitioner to an eligible beneficiary via a telecommunications system (i.e., interactive audio and video telecommunications system that permits real-time communication between the practitioner at the distant site and the Medicare beneficiary at the originating site). Reimbursement for these telehealth services includes payments to physicians or other professionals (at the distant site) for the telehealth consultation, and to the facility where the patient is located (the originating site). A Medicare Advantage plan may provide telehealth services to its beneficiaries, including, but not limited to, using telemonitoring and web-based and phone technologies, and providing medication therapy management via telehealth; however, any telehealth services beyond what is covered under Medicare must be paid for through the Medicare Advantage plan’s rebate dollars as a supplemental benefit.
The report seems to indicate that these benefits apply only to those patients in a Medicare Advantage Program, or ACO. It made not reference to fee for service Medicare. This specific exclusion is prejudical to those beneficiaries. It also makes no mention of Medicaid benefits.
Whle this proposed legislation is a step in the right direction it ignores paymenets for telehealth for postoperative care, and acute medicine contnuing care at home.
The bill is in the Finance Commitee at the present time. Interested parties should contact their Congressional Representatives regarding these shortcomings.
Bipartisan Legislation Proposes Telehealth Solutions for Effective Chronic Disease Management | The National Law Review