WHA WorkGroup Discusses Public Policy with Payer Panel to Advance Telemedicine

January 15, 2019

In order to inform future discussions about telehealth public policy, the WHA Telemedicine Workgroup met last week with invited guests from several Wisconsin health plans to discuss commercial insurance telehealth trends. Workgroup members and guests from Network Health, Quartz, and Security Health Plan agreed that telehealth can be a cost-effective way to expand access to health care and discussed possible public policy solutions for addressing barriers to the greater utilization of telehealth services.

Andrew Brenton, WHA Assistant General Counsel, also updated the Workgroup on WHA’s telehealth advocacy activity in 2018, which included:

Developing and advocating for proposals to address Medicaid regulatory and reimbursement barriers that prevent hospitals and health systems from maximizing use of telehealth. WHA proposals included removal of state Medicaid policies that limit telehealth coverage of otherwise reimbursable Medicaid-covered services, reimbursement of Medicare-covered services enabled by telehealth, reimbursement for targeted telehealth services delivered in the patient’s home or other community setting, and removal of regulatory barriers to the telehealth-delivery of behavioral health care.
Urging the federal Centers for Medicare & Medicaid Services (CMS) to finalize its proposal to pay for a variety of new communication technology-based services—irrespective of the patient’s location. New services included virtual visits, remote evaluation of pre-recorded patient information, and chronic care physiologic monitoring. CMS did finalize these proposals in its 2019 Physician Fee Schedule rulemaking.
Providing Wisconsin’s Congressional delegation with an issue paper encouraging Congress to eliminate the statutory prohibition on Medicare paying for telehealth services when the patient is located in an urban area or at home. WHA also praised Congress’ decision in the Bipartisan Budget Act of 2018 to make limited carve-outs from this Medicare payment limitation for telestroke and teledialysis services.
Hosting several educational webinars for members focusing on telehealth. These included webinars covering (1) state and federal telehealth laws and policies, (2) the use of telehealth by long-term care facilities to reduce hospital transfers, and (3) how to operate a telehospitalist program.

For more information, contact Andrew Brenton at 608-274-1820.

This story originally appeared in the January 15, 2019 edition of WHA Newsletter