CMS approves expansion of telehealth coverage

By: | Tags: | Comments: 0 | March 28th, 2015

CMS Approves American Telemedicine Associations Request to Expand Telehealth Coverage

WASHINGTON, DC – Wednesday, March 11, 2015 – The American Telemedicine Association (ATA) applauds the decision by the Centers for Medicare and Medicaid Services (CMS) to allow Accountable Care Organizations (ACOs) to use telehealth services. The decision was made as part of the release of a new payment and care delivery model: the Next Generation Accountable Care Organization (ACO). The decision extends coverage for telemedicine services to millions of Medicare beneficiaries.

The decision is particularly significant because under this new model, Medicare telehealth services can be covered without regard to longstanding rural and institution restrictions, requiring a beneficiary be located in a rural area and served at a health facility. For the first time, telehealth coverage will be extended to 80 percent of Medicare beneficiaries living in metropolitan areas and from any service originating site, such as their home.

This decision gives Next Generation ACOs the ability to cover and reimburse for telehealth services just like Medicare Advantage (managed care) plans do now.

For nearly four years, ATA has urged CMS to waive all the Medicare restrictions for all ACOs, said Jonathan Linkous, CEO of ATA.This is an important change in CMS policy and attitude. We hope it will encourage CMS and Congress to further open up all value-based payment plans to telehealth.