By: Michaela Keller
Last week, the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, which expands the use of telehealth and remote patient monitoring services in Medicare, was introduced in both the House (H.R. 4442) and Senate (S. 2484). Led by Sen. Brian Schatz (D-HI), the bill includes eight additional sponsors: Senators Wicker (R-MS), Cochran (R-MS), Cardin (D-MD), Thune (R-SD), and Warner (D-VA) and Representatives Black (R-TN), Welch (D-VT) and Harper (R-MS). The bill was introduced at an event on the Hill that included remarks from the each of the sponsors to a room full of hill staff and representatives from several of the supporting organizations. At the time of introduction, 50 organizations, including NACHC, supported the bill.
The CONNECT for Health Act includes a numbers of provisions to lift restrictions on the use of telehealth and remote patient monitoring services in Medicare, including provisions specific to health centers. For example, under current Medicare statute, FQHCs can bill as originating sites, or where the patient is located, but are restricted from billing as a distant site, or where the provider is located. This means that for an FQHC that has multiple sites and a specialist that is located at one site and a patient at another site, the patient cannot see the specialist via telehealth, if the FQHC (where the specialist is located) wishes to be reimbursed. The CONNECT for Health Act would change this to allow FQHCs to be authorized as distant site providers. Many health centers have noted that this change would allow FQHCs to leverage existing providers to better fill workforce gaps and in doing so, improve patient access to care.
The bill goes further to expand access to telehealth services for FQHCs by including remote patient monitoring (RPM) as a reimbursable service within Medicare. For FQHCs that currently wish to utilize RPM services, they unfortunately must absorb the associated costs. Some health centers have found innovative ways to implement RPM through grants and other one-time funding streams and have seen positive patient outcomes; however without appropriate reimbursement, many FQHCs are unable to implement and/or sustain RPM in their coordination of care. The bill sponsors heard this argument loud and clear and included provisions to allow reimbursement within Medicare for remote patient monitoring of patients with chronic conditions, including at FQHCs.
While the future of the bill is far from certain, many supporters believe it has the best chance of any recently introduced telehealth bill given the strong support from the bill sponsors and supporting groups. One outlier that we will be keeping a close on eye is whether or not the Congressional Budget Office (CBO) will score the legislation, meaning that it would provide an estimate of either the costs or savings generated by the proposals included in the bill. What we do know for certain is that Congress is unlikely to pass any legislation with a significant price tag, so provided CBO decides to score the bill, it will be telling in many ways.
In addition to signing on as a supporter of the bill, NACHC joined with a coalition of telehealth and remote patient monitoring advocates to endorse the bill as a component of the Senate Finance Committee’s Chronic Care Working Group request for feedback to improve outcomes for Medicare patients with chronic care conditions. The bipartisan working group plans to address this feedback, which includes telehealth as well as many other provisions, in forthcoming legislation and, should it be needed, provides another legislative vehicle to include the provisions included in the CONNECT for Health Act.
For those health centers that are currently utilizing telehealth programs and for those that wish to implement programs, the CONNECT for Health Act is an important step forward in addressing the need for reimbursement for telehealth and remote patient monitoring. Federal Affairs will keep a close eye on this legislation as it moves forward.