As many of you know, reimbursement for telehealth services is a mixed bag. On the one hand, private payers generally seem ahead of the curve. Many leading private insurers reimburse for telehealth. Generally these coverage policies provide reimbursement for telehealth services when they involve the use of real-time interactive audio, video, or other electronic media
ATA Gets Clarification Regarding New Medicare Reimbursement Rules for Telehealth
Earlier this week, the American Telemedicine Association reported an important clarification regarding the Centers for Medicare & Medicaid Services’ (“CMS’s”) plans for expanding reimbursement for telehealth services provided to Medicare beneficiaries. The October 31, 2014 final rule with comment period regarding payments to physicians generated much excitement in the telehealth community, particularly
CMS Expands Telehealth Reimbursement in New Rule
Who knew?! Buried among more than 1,000 pages of a new final rule with comment period on payments to physicians, released on October 31, 2014, the Centers for Medicare & Medicaid Services (“CMS”) finally has given telehealth providers a glimpse of its plans to expand reimbursement for telehealth services provided to Medicare beneficiaries.
Things That Should Keep the Telehealth Community Awake at Night (Part 1)
We all know that telehealth is going mainstream. The numbers speak for themselves. A leading research firm predicts that 2.8 million patients worldwide used home-based remote monitoring devices in 2012—expected to increase to 9.4 million connections globally by 2017. Another firm projects that the number of patients using telehealth services in the United States will
Telehealth: The Final Frontier (Q&A)
Telehealth is going mainstream. Once limited to rural or remote communities, the use of telehealth is increasingly being used to address critical shortages within many medical specialties (such as dermatology, neurology, radiology, critical care and mental health), and as a more efficient means to provide health care services. Many leading nationally-recognized health care providers, health
Why Not Getting Paid Directly for Telehealth May Not Matter
During and after a recent presentation regarding telehealth before a health care executive group, we were inundated with the following question: Why should a hospital provide telehealth services when often times it will not get paid for those services? It is, on its face, a great question. After all, few of us would want to
The Real Issue in Telehealth: How Can I Get Paid?
As telehealth continues to grow, there are a number of legal, regulatory, and operational issues that threaten to stall its progress. We have tackled many of these issues in previous blog posts. But no obstacle looms larger than the issue of payment. How can providers get consistently and appropriately reimbursed by payers for use
Key Factors That May Influence a State’s Decision on Whether to Expand Its Medicaid Population Under the Affordable Care Act
by Lynn Shapiro Snyder and Shawn M. Gilman
Speculation abounds with respect to the decision that states will make on the issue of whether to expand Medicaid coverage under the Affordable Care Act, now that the Supreme Court of the United States has made the option to abstain a meaningful one. This health reform alert
FDA Approval Is Never Enough
The following may surprise some: FDA approval or clearance is never enough. Not if manufacturers want a commercially successful product. There is no doubt that addressing FDA issues is critical. But without data to show effectiveness, payers will not reimburse a particular product or technology—and even the most promising product will languish in the market
States Jumping on the Telehealth Bandwagon
A significant yet little-noticed trend is underway. And its effects could be far-reaching. A growing number of states are enacting so-called telehealth parity statutes. These laws generally require health insurers to pay for services provided via telehealth the same way they would for services provided in-person. Almost a third of all states have enacted these