Monthly Archives

July 2018

Telehealth Advocates Respond to CMS ‘Virtual Visit’ Proposal

By | Recent Telehealth News

Article Author: David Raths

Source: Healthcare Informatics

Among all the proposed changes the Centers for Medicare and Medicaid Services (CMS) rolled out last week, ones related to telehealth drew considerable interest. Although it can’t use its regulatory power to change the laws that restrict telehealth services paid for by Medicare to rural settings, the agency has instead defined new “communication technology–based services” that could be used for virtual visits with established Medicare patients regardless of such patients’ location, effective Jan. 1, 2019.

In its proposed rule about virtual visits, CMS is seeking comment on whether telephone interactions are sufficient or whether interactions enhanced with video or other kinds of data transmission should be required. CMS also proposes to create a new code to permit separate Medicare payment for store-and-forward technology such as when a dermatologist examines an image of a patient’s skin asynchronously.

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FCC Eyes Support for Telehealth, RPM Projects Serving Rural America

By | Recent Telehealth News

Article Author: Erick Wicklund

Source: mHealth Intelligence

 – Federal authorities are proposing to launch a $100 million program to support telehealth and telemedicine programs for underserved populations, including remote patient monitoring programs that have shown past success in treating rural patients with diabetes and veterans.

The Connected Care Pilot Program, announced by Federal Communications Commission member Brendan Carr and Mississippi Sen. Roger Wicker in a July 11 op-ed piece in the Clarion Ledger, would focus on projects for low-income Americans, particularly veterans and those in rural areas. It would also support certain projects over the next two to three years that measure and verify the value of connected care programs in reducing costs, increasing savings and improving clinical outcomes.

The FCC will vote on a Notice of Inquiry at its August meeting to support the program.

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IRHA & UMTRC Conferences

By | Upper Midwest Telehealth Resource Center

It is hard to believe that 2018 is more than halfway gone!  Just a couple of weeks ago, the Upper Midwest Telehealth Resource Center (UMTRC) staff participated in the Indiana Rural Health Association’s (IRHA’s) 21st Annual Conference!  The conference, held at the historic French Lick Resort and Casino in French Lick, Indiana drew 557 attendees from all over the country.  There were 5 separate telehealth breakout sessions including topics from the culture changes in telehealth programs, the Cincinnati VA telehealth programs, avoiding transfers, emergency telemedicine, and infant mortality with a combined attendance of 140 people.  The National Telehealth Technology Assessment Center staff traveled all the way from Anchorage, Alaska to provide a Telehealth Showcase that allowed participants to compare various telehealth dermatology cameras and digital stethoscopes.

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CMS Proposes Amending Billing Regulations to Medicare Remote Patient Monitoring

By | Center for Connected Health Policy

The Centers for Medicare & Medicaid Services (CMS) has released a proposal rule which would provide a definition to remote patient monitoring (RPM) and amend regulations to allow home health associations (HHAs) to report RPM in administrative costs.  CMS’ logic in interpreting its various statutory obligations for payment that allows them to make this change are detailed in the rule.   They acknowledge from the outset that Medicare is prohibited from making payment for services furnished via a telecommunications system if the services could substitute for an in-person home health service.  However, no prohibition exists for furnishing payment if the service merely augments care, rather than substitutes for an in-person visit.  Furthermore, CMS explains that while a telecommunications system is defined under provisions of the Social Security Act that pertains to telehealth reimbursement as “two-way, real-time interactive communication”, no definition is provided as it relates to the provision of home health care.  Additionally, remote patient monitoring is not considered a Medicare telehealth service as currently defined by Medicare, as CMS has begun reimbursing for RPM code 99091 without applying the limitations and restrictions telehealth services are subject to in Medicare.  Therefore, CMS utilizes a similar definition of RPM as the one included for CPT code 99091 “the collection of physiologic data digitally stored and/or transmitted by the patient and/or caregiver to the HHA”.  Under this definition, RPM is not replacing but instead augmenting in-person care nor do the limitations to reimbursement for telehealth apply.  This interpretation allows CMS to accept RPM services as an administrative cost for HHAs, which can be factored into the costs per visit.

CMS is seeking comments on this and other proposed regulation as well as additional utilization of telecommunication technologies for future rulemaking by August 31, 2018.

For further details, the full document can be accessed in the Federal Register.

Federal Actions Promote Advancement of Telehealth

By | Center for Connected Health Policy

Original Source: Center for Connected Health Policy

CMS Proposes Amending Billing Regulations to Medicare Remote Patient Monitoring


The Centers for Medicare & Medicaid Services (CMS) has released a proposal rule which would provide a definition to remote patient monitoring (RPM) and amend regulations to allow home health associations (HHAs) to report RPM in administrative costs.  CMS’ logic in interpreting its various statutory obligations for payment that allows them to make this change are detailed in the rule.   They acknowledge from the outset that Medicare is prohibited from making payment for services furnished via a telecommunications system if the services could substitute for an in-person home health service.  However, no prohibition exists for furnishing payment if the service merely augments care, rather than substitutes for an in-person visit.  Furthermore, CMS explains that while a telecommunications system is defined under provisions of the Social Security Act that pertains to telehealth reimbursement as “two-way, real-time interactive communication”, no definition is provided as it relates to the provision of home health care.  Additionally, remote patient monitoring is not considered a Medicare telehealth service as currently defined by Medicare, as CMS has begun reimbursing for RPM code 99091 without applying the limitations and restrictions telehealth services are subject to in Medicare.  Therefore, CMS utilizes a similar definition of RPM as the one included for CPT code 99091 “the collection of physiologic data digitally stored and/or transmitted by the patient and/or caregiver to the HHA”.  Under this definition, RPM is not replacing but instead augmenting in-person care nor do the limitations to reimbursement for telehealth apply.  This interpretation allows CMS to accept RPM services as an administrative cost for HHAs, which can be factored into the costs per visit.

CMS is seeking comments on this and other proposed regulation as well as additional utilization of telecommunication technologies for future rulemaking by August 31, 2018.

For further details, the full document can be accessed in the Federal Register.

 

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Delaware Medical Board Tightens Up Its Telemedicine Regulations

By | Recent Telehealth News, Uncategorized

Article Author: Erick Wicklund

Source: mHealth Intelligence, July 9th, 2018

 – Delaware’s Board of Medicine has tightened up its telehealth and telemedicine regulations.

Following a public comment period, the board enacted new guidelines in June that clarify language in the state’s Medical Practice Act, which sets practice standards for virtual care.

The guidelines touch upon two hot-button issues in telemedicine policy: the use of connected care technology to establish a valid physician-patient relationship, and incorporating telemedicine into new substance abuse programs to tackle the nation’s opioid abuse epidemic.

Read More.

 

Model Program: Visiting Nurse Assoc. Uses RPM to Improve Patient Care

By | Center for Connected Health Policy

Original Source: Center for Connected Health Policy

MODEL PROGRAM:
Visiting Nurse Association Uses Remote Patient Monitoring to Improve Patient Care


Early this year, the Visiting Nurse Association (VNA) began integrating mobile applications into the delivery of remote patient monitoring services to home-bound patients. Partnering with Home Recovery Solutions (HRS), the VNA launched the program at its regional branch in Omaha, NE. The program is intended to improve care management and coordination while raising health literacy among the state’s home-based patients. As the health care system continues to migrate towards more cost-effective approaches to care management, the VNA also hopes to maintain high quality care while reducing the financial and work burden of its nurses.

The Omaha VNA distributes 4G enabled tablet computers preloaded with health monitoring and education software and is connected to Bluetooth enabled monitoring devices within the patient’s home. While measuring their own vital information, data is automatically transmitted to the tablets and to the patient’s nurse who is able to track real-time variations in the patient’s health and provide rapid assistance with medication or other health related management. The tablets also provide the patient with daily reminders for taking medication, recording vitals, and answering symptom-related questions. Patients are also educated on their individual conditions through videos and quizzes and may engage directly with their caregiver via the software.

The VNA launched a similar program in its Colorado branch in October 2017. The intervention targets Colorado residents living with heart failure to reduce their rate of hospital readmission and improve health quality. The Colorado program combines the tablets’ vitals tracking capability with video, phone, and text communication to improve care continuity and support traditional in-home visits.

To read more about the VNA’s Nebraska program visit their press release or to learn more about the Colorado program, visit the Colorado VNA’s website.