Telemedicine and Telehealth Reimbursement: History, Legal Constraints, Predictions and Opportunities

Telemedicine and telehealth, increasingly used interchangeably, are uniquely dynamic areas of healthcare delivery and law. As innovators and investors offer ideas, energy, resources, and new technologies, telehealth offers a way to promptly provide credible medical information and assistance to patients that can curtail re-admissions and trips to expensive, overburdened hospital emergency rooms. Telehealth can increase hospital revenues through better performance program statistics, efficient use of resources, and enhanced reputations, and enhance quality of life for the chronically ill and our aging general population. State legislatures have not only recognized the myriad benefits of telehealth, all states now have laws supporting its use. In fact, most states require that commercial and Medicaid plans reimburse providers for telemedicine services – at least when the same services would be covered if rendered in-person. In contrast, CMS has long limited reimbursement for telehealth and expansions have been rare and narrow. Medicare reimbursement has always been and still is limited to care provided by specialists and other clinicians in large hospitals and academic medical centers to patients in rural health professional shortage areas or counties not included in a Metropolitan Statistical Area where special expertise, medical resources, and potentially life-saving technologies are scarce.

In this webinar the speakers will:

• Survey the history of Medicare reimbursement for telehealth services and explain the regulatory limitations, legal constraints on what CMS can do, and its concerns about expanding coverage to in-home care;
• Discuss pending legislation on Medicare reimbursement, such as SB 870, known as CHRONIC, and offer predictions about what will come and when;
• Provide practical suggestions for taking advantage of opportunities now, in connection with both Medicare and direct-to-consumer programs.

Presenters:

• Marcia Augsburger (Partner, King & Spalding)
• David Sayen (Senior Vice President of Client Relations, Gorman Health Group)

You can also follow us on Twitter or Facebook.

Questions

If you have questions concerning this Roundtable Webinar, e-mail lifesciences-healthcare@kslaw.com.