Draft bill proposes equal Medicare reimbursement for telehealth, in-person visits

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A draft bill in the House of Representatives proposes reimbursing Medicare providers at the same rate for telehealth and in-person visits. Members of the House Energy and Commerce Committee's subcommittee on Health began circulating the draft on Monday, according to news sources.

The bill would expand reimbursement for telehealth services that address unmet needs, substitute for an in-person visit, reduce hospital readmissions or enable a person to move to a “lower level of care.” The draft version leaves space for later versions to include more specific criteria for meeting these requirements.

A provision also states that the law would not have to be implemented if the chief actuary of the Centers for Medicare & Medicaid Services were to certify that doing so would increase overall Medicare costs.

Medicare reimbursement for telehealth currently is limited, due in part to fears that expanding coverage would lead to overutilization and unsustainable costs. However, some research has shown that broadening telehealth actually would cut costs, in part by preventing emergency room visits.

Groups such as the Alliance for Connected Care and the Health IT Now coalition praised the bill. However, it should go further, the coalition's Executive Director Joel White stated. The law should ensure that physicians can provide telehealth services across state lines, even if they are not licensed in the state where the patients are, he said.

Eight members of the House subcommittee are supporting the draft, including the chairman of the full Energy and Commerce Committee, Rep. Fred Upton (R-MI). The bill could be formally introduced as early as February, according to Politico.