HHS Reports Progress on Telehealth Regulations

The U.S. Department of Health & Human Services is making "significant progress" toward new and revised rules that would save the healthcare industry billions of dollars, including ones that will address privileging and credentialing and documentation regulations for both in-person and telemedicine visits, the agency reported. Many of the rules--both proposed and final--increase efficiency and alleviate administrative burdens on physicians, HHS wrote in its most recent update. HHS reported on health IT-related efforts, including a proposed rule that would allow patients to more easily access their clinical lab test results, and two that would affect telemedicine programs. One would revise the Medicaid home health service definition under the Affordable Care Act to add a requirement that physicians document face-to-face encounters, including those conducted using telehealth technology, with the Medicaid eligible individual within specified timeframes. HHS says this rule would save an estimated $1.2 billion by 2019. The second rule, which has already been finalized, revises the conditions of participation for hospitals and implements a new credentialing and privileging process for physicians and practitioners providing telemedicine services. "This specific reform is estimated to result in $13.6 million savings to hospitals per year," HHS reported. "These revisions will provide more flexibility to small hospitals and [critical access hospitals] in rural areas and regions with a limited supply of primary care and specialized providers. Hospitals and CAHs will support this as it reduces the burden associated with the credentialing and privileging process." Meanwhile, at a meeting of the National Rural Health Association (NRHA) this week in Washington D.C., members made a series of recommendations and statements about reimbursement for telehealth. Among them:
  • Reimbursement for services provided through telehealth should be made based upon medical effectiveness and utilization and not based upon or limited to particular delivery platforms or locations.
  • The Medicare law should be expanded to allow anything currently covered by Medicare to be reimbursed when provided through telehealth by appropriately licensed or credentialed providers otherwise eligible for Medicare reimbursement.
  • A telemedicine payment methodology should be provided so that a professional fee is paid to all providers necessary to that particular encounter, including a technical fee to the facilities to cover costs associated with the technology at rates to be determined by the HHS Secretary.
  • A separate Medicare billing code for telehealth consultations should be implemented to assist in monitoring the use of telehealth.
  • A federal policy should be adopted to allow telemedicine providers to receive deemed status and to allow for healthcare facilities receiving telehealth services to perform credentialing by proxy. If a provider is already credentialed at a Medicare participating facility, that credential would be sufficient for providing telemedicine services at another facility. HHS also made note of a review that's underway of a Food and Drug Administration rule for medication bar codes. Under the current rule, drug manufacturers must use a certain type of bar code to identify the drug, but since that rule was imposed, many more types of bar codes and bar code readers have hit the market. FDA will conduct an economic review to determine if the rule should be modified to include these new technologies, according to HHS.