TeleHealth Covered by Medicare: A Fit for Your Senior’s Needs?

Technological evolution — and sometimes revolution — for the benefit of our senior loved ones is one of our favorite topics here at Senior Care Corner.

We are strong supporters of the role technology can play in the well-being, both physically and mentally, for all of us as we age.

Especially exciting is the thought of what advances in technology can do to enable seniors to age in place and enjoy healthy, safe and comfortable lives in the homes of their choice.

Recently we read about a proposed bill that would expand telehealth coverage for medical care to our seniors through the Medicare and Medicaid program.

Telehealth, sometimes referred to as telemedicine, is the use of telecommunication technologies to provide healthcare services from a distance via two-way interactive communications between patients and providers.

Telehealth Coverage by Medicare

According to the Centers for Medicare and Medicaid Services (CMS) coverage is provided for Telehealth Services as follows under Medicare Part B services:

“As a condition of payment, an interactive audio and video telecommunications system must be used that permits real-time communication between you, the physician or practitioner at the distant site, and the beneficiary, at the originating site. Asynchronous “store and forward” technology is permitted only in Federal telemedicine demonstration programs conducted in Alaska or Hawaii.”

The following medical providers are allowed to provide Medicare-covered telehealth services:

  • Doctor
  • Physician extenders such as physician assistants and nurse practitioners
  • Clinical Psychologists and Clinical Social Workers
  • Registered Dietitians
  • Clinical Nurse Specialists

Coverage for telehealth has been in effect since 2001 but only in rural under-served areas where healthcare providers and seniors are not close to one another.

A newly proposed bill, called the Telehealth Promotion Act of 2012 (HR 6719), calls for an increase in the usage of telehealth nationwide. Coverage would extend to all beneficiaries covered by Medicare, Medicaid, the Department of Veterans Affairs, Tricare, federal employee health plans and the Children’s Health Insurance Program.

Hopes for Greater Access with Lower Cost

This bill is estimated to make 75 million Americans eligible for coverage of telehealth and mhealth under this proposed Act. It is seen as a win-win situation, not only to provide much needed care to those in need but also provide long term healthcare and prevention strategies to reduce the cost of providing care. This is accomplished through reduced hospital readmission rates, allowing Accountable Care Organizations (ACO) to use telehealth as a substitute for in person care, and adjusting reimbursement timelines to facilitate remote patient monitoring.

This change in service model this represents will lead to more effective and efficient use of the healthcare system, according to the bill’s supporters.  However, the bill is currently in a House subcommittee as it will likely create a situation where costs upfront may outweigh the vision for long-term cost savings.

We’re excited about the possibilities telehealth services can bring to our senior loved ones and will keep you updated on the topic.

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