services for seniors covered by Medicare. The Telehealth Innovation and Improvement Act, introduced by Sens. Cory Gardner (R-Colorado) and Gary Peters (D-Michigan), would “expand access to healthcare in both rural and urban areas to cover additional telehealth services” than the more limited Medicare benefit under the program today. Companies like American Well are growing rapidly, providing telemedicine services to health plans,... [+] employers and physicians. It’s the latest potential expansion of insurance coverage via telehealth, which offers access to physicians and patients via smartphone, tablet or computer. Employers and private insurers are already embracing the trend as a way to make healthcare more convenient and avoid costly and unnecessary trips to the emergency room or a more expensive physician’s office. The U.S. Senate legislation would require the U.S. Department of Health and Human Services to allow “eligible hospitals to test telehealth services” through the Center for Medicare and Medicaid Innovation (CMMI). “It would...incentivize the healthcare industry to develop new technologies that could potentially reduce costs and improve patient health,” Gardner said. Though the legislation would still have to pass the full Senate and the House, the introduction of rare bipartisan legislation in an intensely divided Washington is seen as a victory for telehealth providers like Teladoc, MDLive and American Well. These companies have already benefited from expanding commercial coverage of telehealth consultations from large insurers like Aetna , Anthem , UnitedHealth Group and most Blue Cross and Blue Shield plans. Existing regulations have been a hurdle to the industry, says Dr. Roy Schoenberg, chief executive officer at telehealth provider American Well, who described the legislation as a “strategic bull’s eye.” “The approach is to force CMMI to clear its constituents to use telehealth as a way to measure its outcomes,” Schoenberg said. “Remarkably, while Americans under 65 have almost ubiquitous access to the world of online healthcare, those of us who are frail, the homebound, those who need it frequently and are challenged the most to access it–our 65-plus elderly–are denied access to it. A mind boggling social injustice that is excused by red-tape and antiquated pre-iPhone regulations.” But some are leery that expanding telehealth coverage merely adds to cost by increasing usage of services by Americans who already have traditional access to doctors. A March study in the journal Health Affairs estimated that “12% of direct-to-consumer telehealth visits replaced visits to other providers and 88% represented new utilization.” But supporters say the legislation calls for ways to examine cost-effectiveness and takes into account what Americans in rural areas are spending just to travel to a doctor or hospital for routine care and preventive screenings that are telehealth’s sweet spot. “The legislation would require CMS’s Center for Medicare & Medicaid Innovation to examine whether delivery reform initiatives, such as ACOs and bundled payments, can demonstrate how telehealth and remote monitoring services can help providers achieve program goals,” says J.C. Scott, chief advocacy officer for the Advanced Medical Technology Association (AdvaMed), which includes Medtronic , Philips , Qualcomm , ResMed and Intel among its membership. “We believe that extending coverage for these services can produce savings in the Medicare program while increasing access and improving or maintaining quality of care–particularly for patients in rural areas or with long distances to a hospital or clinic.”
Washington telehealth providers, including Teladoc, MDLive and American Well, are championing bipartisan legislation calling for expanded access to telehealth services for the country's pensioners covered by Medicare. The Telehealth Innovation and Improvement Act, dubbed a "strategic bull’s eye", would enable eligible hospitals to test telehealth services through the Center for Medicare and Medicaid Innovation (CMMI). Currently, patients aged 65 and over are unable to access telehealth due to "red-tape and antiquated pre-iPhone regulations". The bill has to pass both the Senate and the House.