Medicare Compliance & Reimbursement

Don’t let Medicare coverage keep you from using remote technology.

In addition to Congress’ push for more Medicare coverage of telehealth via the Medicare Telehealth Parity Act of 2014, several states have parity laws for private payer coverage of telemedicine. 

For current news on your state’s standing in telehealth legislation, check out the following link from the American Telemedicine Association: http://tinyurl.com/kgbovfl. 

If you’re itching to use the growing forms of technology to enhance your patient care, but feel stuck due to lack of parity legislation in your state, remember: “This is not a question of whether telemedicine can be used to provide care; it’s whether or not it can be reimbursed,” points out Mark Silberman, health care partner for Duane Morris in Chicago. “That’s one of the common things people forget; just because Medicare doesn’t reimburse something doesn’t mean it’s a prohibitive form of healthcare.”

Promising: If your state has limited or no coverage, it may not be for long. “Three or four years ago, around seven states passed their own parity legislation requiring private reimbursement for telemedicine, and in just a couple years, now we have 20-22 states with parity legislation,” notes Alexis Gilroy, JD, partner with Jones Day in Washington, D.C. and co-chair of the American Health Lawyers Association’s Telemedicine and E-Health Affinity Group.

“Many providers have been doing telemedicine without good or any reimbursement for years, but there is a strong push, at least from the private payer end, that telemedicine has finally proven itself effective and that it is worthy of reimbursement,” Gilroy says.