Senate telemedicine bill CHRONIC introduced to expand services to chronic conditions, at-home care

By Heather Mack
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Federal standards for telemedicine reimbursement are becoming more of a reality. The newly reintroduced Senate Bill 870, called Creating High Quality Results and Outcomes Necessary to Improve Chronic Care Act of 2017 (also referred to as CHRONIC), aims to hone in on Medicare payment reform in order to expand telemedicine services for chronic disease management and at-home care coordination.

Along with expanding telemedicine coverage under Medicare Advantage Plan B in 2020 and giving Accountable Care Organizations more freedom to use telemedicine, key provisions in the CHRONIC bill extend the Centers for Medicare and Medicaid Services’ home-based primary care teams for people with multiple chronic conditions. The bill would extend this “Independence at Home” demonstration to two years and increase the maximum allowable number of Medicare beneficiaries in the program from 10,000 to 15,000.

Geography is also a feature of CHRONIC, with one proposal seeking allowance of a patient’s home dialysis facilities to count as a recognized originating site for telehealth visits (and their payments) and another eliminating the locational restrictions on telestroke consultations.
While telemedicine access, regulation and reimbursement and has historically been a largely state-by-state issue, more federal legislation is on the docket this year. A bipartisan Senate bill called the Telehealth Innovation and Improvement Act was just introduced this week, and seeks a requirement to the Center for Medicare and Medicaid Innovation (CMMI) to “test the effect of including telehealth services in Medicare health care delivery reform models.”

In other telemedicine news, Texas has further progressed with two pieces of legislation aimed at children. The state House Public Health Committee passed a bill that would establish a resource program in rural Texas to set up more pediatric telemedicine-connected facilities, and the Committee also held a hearing on a bill that would allow schools to bill Medicaid for certain telemedicine services.