Law and Policy in Telemedicine

Medicare and Medicaid Publications

• Online articles
• Publications

Online articles

• 2001 OAT Report to Congress
  Author/editor: OAT
  Date: May 22, 2001
  Includes sections on Medicare and Medicaid reimbursement, as well as a section on Other Payment Coverage, which briefly describes the state of third party payer coverage for telemedicine.
• Broader Medicare Reimbursement for Providing Telemedicine Seems Doubtful
  Author/editor: Stephen Barlas
  Date: November/December 2000
  From Geriatric Times, Vol. I Issue 4, current Medicare limitations on payments to physicians and other health care providers for telemedicine consultations have caught the attention of some members of the U.S. Congress. The limitations were put in place by the Balanced Budget Act (BBA) of 1997, which allowed Medicare to pay for telemedicine consultations for Medicare recipients beginning in January 1999.
• Happy in the Heartland
  Author/editor: Michael Gibbons
  Date: December, 2003
  Tucked inside the proposal to revamp Medicare now working its way through Congress, overshadowed by the closely watched debate about prescription drug benefits for seniors, are several amendments designed to help rural facilities recruit and retain physicians by raising their Medicare reimbursement rates. From Advance for Nurse Practitioners.
• Medicaid and Telemedicine
  The Centers for Medicare and Medicaid Services (CMS) report regarding Medicaid reimbursement for services provided via telemedicine. Includes a list of states reimbursing for telemedicine under Medicaid.
• Medicare Reimbursement for Telehealth Encounters
  Author/editor: Joe Tracy, Thelma McClosky-Armstrong, Rob Sprang, Sam Burgiss, Jim Reid, Donna Hammack
  Date: October 5, 1999
  A position paper. Comments in response to the Balanced Budget Act (BBA) of 1997 mandate that the Health Care Financing Administration (HCFA) begin reimbursing for select telehealth consultations on January 1, 1999. Adobe PDF
• Teleconsultation reimbursement changes
  Author/editor: James V. Schuster, Esq.
  Date: November, 1996
  From the Physician's News Digest. Thus far, the federal Health Care Financing Administration (HCFA) has taken a conservative approach to Medicare reimbursement for telemedicine. Yet, the agency's approach has recently received harsh criticism from members of Congress and the private sector, which may suggest that the time for covering physician telemedicine consultations (teleconsultations) might just be the here and now.
• Telemedicine for the Medicare Population: Executive Summary
  Author/editor: not listed
  Date: February, 2001
  Prepared by the Oregon Health Sciences University Evidence-based Practice Center, this report assesses specific telemedicine study areas, with a focus on those that would substitute for face-to-face medical diagnosis and treatment of the Medicare population. Thus, this report targets face-to-face clinical specialties (as opposed to radiology and pathology) and the Medicare population (adults as opposed to children and pregnant women).
• Telemedicine Reimbursement Report
  Author/editor: n/a
  Date: October 2003
  From HRSA's Office for the Advancement of Telehealth (in conjunction with the Center for Telemedicine Law), a report on the status of reimbursement for telemedicine.
• Telemedicine Report to Congress 1997
  Author/editor: Joanne Kumekawa, Dena S. Puskin, Sc.D., Thomas Morris, editors
  Date: January 31, 1997
  Congress asked the Secretary of Commerce, in consultation with the Secretary of Health and Human Services and other appropriate departments and agencies, to submit a report on the use of advanced telecommunications services for medical purposes. Specifically, the Telecommunications Reform Act of 1996, requires a summary of the Joint Working Group on Telemedicine's (JWGT) activities as well as findings from federally-funded telemedicine studies and demonstrations. In addition, Congress requested that the report examine questions related to patient safety, the efficacy and quality of services provided and other legal, medical, and economic issues.
• Telemedicine: Follow the Money
  Author/editor: Dena Puskin
  Date: September 30, 2001
  This article traces the development of current Medicare telemedicine payment policies, beginning with the BBA of 1997 and including current Medicare payment legislation. Issues related to telemedicine payment by both Medicare and other third party payers are presented; implications for the future and the role of the nursing community are discussed. From the Online Journal of Issues in Nursing.

Publications

• A State-by-State Comparison of Medicaid Reimbursement Policies [pdf]
  Telemedicine for Children with Special Health Care Needs: A State-by-State Comparison of Medicaid Reimbursement Policies and Title V Activities from the Institute for Child Health Policy University of Florida
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• Medicare Programs; Revisions to Payment Policies: Final Rule November 1, 2001
  On November 1, 2001 the Health Care Financing Administration announced its final rule regarding the Department of Health and Human Services Medicare Program; Revisions to Payment Policies and Five-year Review and Adjustments to the Relative Value Units Under the Physician Fee Schedule for Calendar Year 2002. Section F pertains to Medicare Telehealth Reimbursement Regulations.
• Payment Obstacles to Hospital, Physician and Patient Telecommunication
  Author/editor: Richard L. Reece, M.D
  Date: June 17, 2004
  Physician-patient telecommunication is gaining traction. It promotes better medicine, improves safer care, cuts costs, minimizes confusion and misunderstanding, leads to better patient relationships, avoids malpractice suits, and can be financially rewarding through greater productivity. Furthermore, payors are beginning to experiment with paying for online consultations and for telemedicine consultations at a distance. But for many reasons, most payors and patients are reluctant to pay for telecommunication innovation.
• Telemedicine for the Medicare Population: Full Report
  Author/editor: Hersh, W.R.
  Date: July 2001
  Prepared by the Oregon Health Sciences University Evidence-based Practice Center for the Agency for Healthcare Research and Quality, this report assesses specific telemedicine study areas, with a focus on those that would substitute for face-to-face medical diagnosis and treatment of the Medicare population.

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Links updated on 8/27/2008 10:40:28 PM