American Telemedicine Association’s policy duo, Jonathan Linkous, CEO, and Gary Capistrant, Senior Director of Public Policy, return with updates and new information regarding telemedicine.
In the wake of the Government shutdown, Congress continues to debate several different legislative proposals and provisions. One aspect involves the repeal of the medical device tax which charges a 2.3% tax on all medical devices; including some telemedicine components. The provision to repeal this tax is on the table; however, Capistrant says while this is possible it is not probable.
Bill HR 3077 was introduced by Congressmen Devin Nunez and Frank Pallone to allow providers with one state license to provide care via telemedicine to Medicare beneficiaries wherever. A similar bill, HR 2001, by Charles Rangel would provide the same for VA beneficiaries. These bills will essentially make one license enough for healthcare providers working with federal agencies or federal programs. This will help expand access to telehealth services which can provide numerous cost benefits to both patients and providers.
Greg Harper’s bill, mentioned in the last webcast, to improve Medicare coverage for telehealth has not been introduced because of the shutdown. However, because this is the beginning of a two year congressional session, even if this bill does not get passed this fiscal year there is still next year.
The FDA has released final guidance on mobile medical applications in an attempt provide clear direction to device makers and application developers as to what constitutes as a medical device and needs to go through the FDA approval process. Their regulatory focus will be on medical apps that present a greater risk to patients if they do not work as intended. Additionally, the FDA will develop a web-based platform for developers to seek advice about devices and situations. This will provide better guidance and make it clear as to when the FDA needs to be engaged and what the provisions will be.
Fiscal year 2013 was a very busy year for state telehealth legislation and this year will be more of the same. Much of the legislation that was not enacted last year will be reintroduced in 2014. At the top are the 10 states that had proposals for parity with private insurance companies that were not enacted. These states include Connecticut, Florida, Illinois, Massachusetts, Ohio, New York, South Carolina, Tennessee, Washington, and Pennsylvania.
In other news, it was reported that an Oklahoma doctor was disciplined for using Skype to treat patients. However, the use of Skype was inconsequential to what physician Thomas Trow was doing wrong. The main disciplinary issues were Trow’s over prescription of narcotics and failure to maintain medical records. In fact, Trow had previously received disciplinary action from the Oklahoma Medical Board (OMB) for over prescribing, narcotics violations, and record violations. The OMB filed action September 12 and 16 and put out proposals that, according to Capistrant, may be over-reaching and affect telemedicine. The ATA is working with the OMB to ensure these new provisions do not negatively affect telehealth services.
ATA is currently working on a series of guidelines and telehealth best practices for remote ICU, burns and wounds, and primary and urgent care. They are currently awaiting review and approval from the Board and should be available in the next few months.
The next This Month in Telemedicine webcast is scheduled for October 29, 2:00-3:00PM EST.