Telemedicine pilot bill tries its luck again

By Jonah Comstock
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Senator John Thune

Senator John Thune (R-SD)

Senator John Thune (R-SD) and Sen. Amy Klobuchar (D-MN) have reintroduced the Fostering Independence Through Technology (FITT) Act (S 596), a telemedicine bill that has now been introduced five times since 2005, to the Senate.

The FITT Act would require the Department of Health and Human Services (HHS) to launch a remote monitoring pilot with home health agencies for Medicare beneficiaries. The pilot would establish cost-saving performance targets for future remote monitoring initiatives.

“This innovative RPM technology has the ability to revolutionize patient care and dramatically reduce the amount of money Medicare spends on hospital re-admissions each year,” Thune said in a statement. “Not only could this technology reduce costs and improve health outcomes, but it also offers patients the individual freedom to stay in their homes, reducing costs associated with nursing homes and long-term care facilities."

The bill is similar to the most recent version, introduced in 2011, but includes minor changes. The definition of remote monitoring services now specifically excludes audio telephone calls, text email consultations, and faxes, a change that might be calculated to reduce the Congressional Budget Office's assessment of the bill's cost. The bill also now makes reference to the readmission penalties under the Affordable Care Act, which wasn't in place the last time the bill was introduced, and changes the deadline for HHS to make a report to Congress from five years to three years.

Jonathan Linkous, CEO of the American Telemedicine Association, said that although ATA supports the bill, he doesn't consider it a significant measure -- and significant adoption of telemedicine and remote monitoring is sorely needed.

"We'll support it," Linkous said, "but when the boat's half filled with water, a teacup is not really what you need."

He went on to say that the danger of pilot programs is that Congress will treat them as "snooze alarms" -- using them as an excuse to delay larger action, like the Telehealth Promotion Act Representative Mike Thompson introduced at the end of the 2012 Congress. In addition, while there may have been a need to prove the effectiveness of remote monitoring in 2005 when the bill was initially introduced, now, in 2013, it's a different story.

"The need has been well-documented, well-evidenced. There's some concern about how you do it and when you do it, but there's no real question that we should be doing it," he said. "It's not time to test, its not time to study, it's time to go."

Linkous said the bill hasn't failed in the past because of strong opposition, but because of a lack of strong backing, noting that a pilot program doesn't have a large enough impact to attract wide, bipartisan support.

That the bill is being co-sponsored by a Republican and a Democrat is a good first step toward securing that support, and it's clear from the new versions that the sponsors believe the readmission reduction requirements of the Affordable Care Act will bolster the bill. In addition, telemedicine is more commonplace and accepted now than it was in 2011. Whether all that will be enough to get the bill passed remains to be seen.

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