Needed Directions

We clearly have to do our homework about home telehealth funding. Recommended background reading on this topic is provided right here.

Background Readings

Article

Marta, MR (2003), Telemedicine payment: then and now, Health Care Financial Management, July 57 (7): 50.

Provides excellent summary materials about available funding sources for telemedicine in general, not home care specifically. Note is made of certain states’ HMOs’ practices of funding telemedicine—e.g., in Louisiana, discrimination against providing telehealth services is prohibited. Details are also provided about telehealth provision of home health care under the Benefits Improvement and Protection Act of 2000 (known as BIPA, and effective October 2001) and how, not whether, Medicare monies could be used under PPS billing.

White Papers and Overviews of Reimbursement for Telehealth

A general White Paper on reimbursement for telemedicine that was developed by the ATA Policy Committee discusses Medicare reimbursement, current CPT coding and modifiers, and future needs for wider use and payment of telehealth under Medicare and Medicaid. It is available at: http://www.atmeda.org/news/Reiumburement%20White%20paperfinal.pdf and then click on the ATA White Paper on Reimbursement.

One more report of interest on telemedicine reimbursement, prepared by the Center for Telemedicine Law, provides an overview of existing state reimbursement policy (for Medicare, Medicaid, and other major funding players). A state-by-state table of enrollee numbers in Medicaid and Managed Care Plans is provided on pp. 15-16. Again, home health information must be searched out separately once certain contact information is gleaned from this report. This Telehealth Reimbursement Report is available online at: http://telehealth.hrsa.gov/licen/.

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