Last month, Jonathan Woodson, M.D., the Assistant Secretary of Defense for Health Affairs for the U.S. Department of Defense, issued a memorandum that effectively changes the Military Health System ("MHS") policy on telemedicine. The new policy enables the MHS to treat patients via telemedicine when the patients are located in their homes or other locations "deemed appropriate by the treating provider." Previously, similar to the originating site restrictions found in the current Medicare reimbursement laws, MHS providers could only treat patients via telemedicine if the patients were physically present at a military treatment facility or other designated facility, which did not include the patient's home.
The memorandum notes that one of MHS's major focus areas over the past year has been promoting additional options for accessing care. And the Assistant Secretary has been an outspoken advocate for expanding telemedicine services in the MHS. For example, during the keynote speech at the American Telemedicine Association's 2014 conference, he noted that as care standards continue to evolve, it's imperative that the MHS embrace telehealth.
The memorandum represents a long awaited expansion and implementation of the 2011 ServiceMembers' Telemedicine and E-Health Portability (STEP) Act. While the STEP Act removed the requirement that all health care services provided to military members and their families be delivered in a military facility (whether in person or via telemedicine), the Act did not apply to TRICARE providers and did not allow telemedicine to be provided to patients in their home. The memorandum removes both of these barriers to widespread use of telemedicine for military members and their families.
The DoD's expansion of telemedicine services comes on the heels of an unprecedented number of telehealth bills introduced in the 2015 legislative session, which we summarized in a previous post found here. Additionally, on February 24th, a bipartisan bill known as the CONNECT for Health Act was introduced in the Senate. This legislation is expected to make it easier for the government to cover telemedicine as a benefit in Medicare Advantage plans. You can read more about this proposed legislation here.
Although the DoD's memorandum and other federal legislative efforts reveal a willingness to move away from more traditional telemedicine to care delivered in an online setting with the patient at home, progress on the reimbursement front has been slow. As evidenced by the CONNECT for Health Act, talk in Washington appears to be shifting to telemedicine reimbursement, rather than focusing on access. Both commercial payers and the government need to move more quickly, however, to ensure that telemedicine is a viable option for patients.
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