Reimbursement
CTeL has a long history of looking at reimbursement issues related to telehealth. CTeL is the only organization to publish an independent sourcebook related to reimbursement for telemedicine. Its Reimbursement Sourcebook and State Telemedicine Reimbursement Guide address a broad range of legislative and regulatory issues involving telemedicine reimbursement policies through a variety of mechanisms at the federal and state levels, including, for example, Medicare, Medicaid, and private insurance -- all of which pay for telehealth in varying degrees.
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“Probably no topic is more often identified as an ‘issue’ or a ‘barrier’ to innovation, demand and investment in telehealth than reimbursement for encounters.”
Innovation, Demand, and Investment in Telehealth, US Commerce Dept., Feb. 2004
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Beginning in 1996, CTeL created a Reimbursement Task Force to address the many issues surrounding telemedicine reimbursement and has continued to work in this area through reports, publications, workshops, and educational meetings.
In 2002, CTeL wrote a reimbursement report under contract to HRSA’s Office for the Advancement of Telehealth that outlined Medicare policies with regard to telehealth services, and performed a reimbursement survey of Medicare and private payers about telehealth reimbursement policies. CTeL is seen as the foremost public policy expert in this area.
CTeL has monitored and consulted with organizations regarding state reimbursement policies, including:
- National Governors Association
- Office for the Advancement of Telehealth, HRSA, HHS
- Southern Governors Association
- State of Nebraska
- State of Texas
- Western Governors Association
CTeL was recognized for its analysis and cost estimates in a 2004 report on telemedicine issued by the US Commerce Department entitled, Innovation, Demand, and Investment in Telehealth states:
Members of Congress have questioned the variance of Centers for Medicare and Medicaid (CMS) and Congressional Budget Office (CBO) costing projections of proposed telehealth provisions, based on econometric models, with actual outlays. For example, CMS projections ranging from $20 million to more than $1 billion as a result of BIPA provisions have, to date, proven to be far greater than actual. CMS reports that, by the end of FY2002, only 1,350 billings for telehealth coverage specified under BIPA have been approved, amounting to less than $50,000 in reimbursement. The CBO substantially lowered its estimates based in part on data provided by OAT and the Center for Telehealth & E-Health Law (CTeL). The CTeL/OAT estimates of expanding telemedicine payments under BIPA ranged from $50-$100 million over five years. As reported at the CTeL sponsored Telehealth Leadership Conference, that number is actually closer to $1.2 million over four years. There is much work to be done on communicating the value of telehealth to public policy makers.
In 2004-2005, CTeL working with the University of Colorado Health Sciences Center performed an analysis of whether skilled nursing facilities should serve as originating sites for telehealth for a report to Congress required under the Medicare Modernization Act. That report is currently under review at the Department for Health and Human Services.
Center for Telehealth & E-Health Law
1500 K Street, NW, 11th Floor, Washington, DC 20005-3317
202.230.5090 Main | 202.230.5300 Fax | www.CTeL.org | info@ctel.org
Copyright © 2005. Center for Telehealth & E-Health Law.
Information presented on this site is for information purposes only and should not be relied upon as legal advice.
For information about your specific circumstances, please consult legal counsel.
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