Senator Mazie K. Hirono, (D-HI) a member of both the Senate Armed Services and Veterans Affairs Committees with Senator Rob Portman (R-OH) have issued an amendment (S.A. 2114) to be incorporated as part of the newly drafted National Defense Authorization Act (NDAA). The amendment requires DOD to issue a report on the current status of telehealth initiatives.
The report will need to provide plans on how DOD plans to integrate telehealth into the military healthcare system. Specifically, the DOD report will have to specify how the military will address privacy concerns and the challenges in implementing telehealth in group treatment and therapy and how to provide outreach to rural areas such as therapy obtained in the home.
This issue is particularly important for veterans suffering from Traumatic Brain Injuries (TBI). TBI is often called the signature wound of the Iraq and Afghanistan wars with over 280,000 veterans affected since 2000 according to the Defense and Veterans Brain Injury Center. It is also estimated that 30 percent of the men and women who have spent time in war zones experience PTSD.
As reported by the American Telemedicine Association, the Senate Finance Committee approved two amendments to improve Medicare coverage for telehealth services. Both amendments were authored by Senator John Thune (R-SD).
The first amendment lifts restrictions on the use of telehealth for any health system financed under an alternative payment model such as Accountable Care Organizations or medical homes beginning in 2017. This is important as Medicare payments for physicians and practitioners shift to value-based all- inclusive payment methods.
The other amendment establishes a Medicare demonstration program on remote patient monitoring for home health agencies and other entities. This move advances Senator Thune’s “Fostering Independence Through Technology Act”.
The Strategic Growth Rate (SGR) formula is being addressed by the Senate and the House. Both the Senate Finance Committee and the House Ways and Means Committee have passed legislation correcting the goal to permanently fix the broken SGR formula.
The legislation would repeal the SGR update mechanism, improve the fee-for-service system by streamlining Medicare’s existing web or quality programs into one value-based performance program, promote movement to alternative payment models, focus more on coordination and prevention, and would give patients more access to information.
This legislation will now move out of Committee onto the floor to hopefully create a new permanent framework for physician payment in Medicare. Meanwhile, the House Rules Committee has added a temporary “doc fix” as a means to stall off physician payment cuts until at least the end of March.