Telehealth is increasingly being recognized as a valid form of physician and practitioner service. The proof of the pudding, however, is in the eating, as the adage goes. CMS, the Center for Medicare & Medicaid Services released its proposed expansion of telemedicine services for 2015 on July 4th. Let freedom ring! And let the rule stand!
The rule is revealed on page 140 of the 609 page document and includes annual wellness visits, both initial and subsequent, that include a personalized prevention plan. This is music to my ears as it has become a necessity to individualize plans in this population as the co-morbidities escalate. Shifting personal responsibility to a self-care management model is an idea whose time has come. The Medicare population is burgeoning and care-giver burnout has become a looming issue.
Expanding telehealth services to include wellness visits, psychotherapy, psychoanalysis and prolonged evaluation and management services will decrease the burden on the patient/person, the family and the care-givers. The rule is open for comments through Sept.2.
Medicare telehealth services include consultations, office visits, office psychiatry services when furnished via a telecommunications system. In order to receive payment for these visits, one must meet these requirements. An interactive telecommunications system is defined by Medicare as multimedia communications equipment that includes, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and the distant site practitioner. Telephones, facsimile machines, and electronic mail systems do not meet the definition of an interactive telecommunications system.
The Federation of State Medical Boards reflects the understanding that telehealth is, not only here to stay, but is actually healthcare, period. In their recent proposal for a model telehealth policy guide, which was approved in April, FSMB says that a physician-patient relationship must be established for physicians to engage in telemedicine, but that a relationship can be initiated whether or not there has been an encounter in person between the physician and patient. This paves the way for acceptance of synchronous office visits via telecommunications systems. The portability of state licenses across lines still remains in discussion. For the time being, a patient can only be “seen” by a doctor licensed in the state where the patient resides. State Medical Boards are collaborating on a compact agreement to make state licenses portable.
Telehealth has long been championed by the American TeleMedicine Association and they, and you, are now reaping the benefits of their persistence.
Telehealth makes wellness and the ease of living to a ripe old age a reality.