Page 4 Telehealth Enhancement Act of 2015

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Impact and Analysis

HR 2066 would create unprecedented new opportunities to optimize the use of RPM and
enhance care coordination, but there would be no requirement for this to take place.

• CMS is given authority (but not required) to contract with state Medicaid agencies to
provide coordinated care through a health home for individuals with chronic conditions
and requires a provider in such an arrangement to report a plan for the use of RPM for
quality control purposes. It is important to note that this only applies to states that have
opted in their state plan to provide for medical assistance to eligible individuals with
chronic conditions.

• CMS is given authority (but not required) to contract with national or multi-state regional
centers of excellence to provide coordinated care through medical homes to individuals
with long-term illnesses, or medical conditions that require regular medical treatment,
advising, or monitoring. The bill requires these medical homes to have a plan for the
use of health information technology in providing services, which includes RPM.

• Centered on the success of the Arkansas ANGELS program, HR 2066 gives states the
option (but does not obligate them) to amend their state plan to set up “birthing
networks” for maternal-fetal and neonatal care. Birthing network services include the
use of health information technology to link services and provide monitoring when
feasible and appropriate.

• ACOs are given the flexibility (but not required) to cover telehealth and RPM services as
supplemental health care benefits to the extent a Medicare advantage plan is permitted
to provide coverage of supplemental benefits.
In all four of the sections mentioned above, the new allowances will only have an impact if the
key stakeholders in each of the programs choose to take advantage of them.

The manner in which RPM is referred to separately from telehealth in many of the previously
mentioned sections gives the appearance that it does not fall under telehealth. Additionally,
there is no indication that store-and-forward is being considered under telehealth in these sec-
tions, and it is unclear if this delivery mode would be available in these new programs.

HR 2066 also makes additions to the list of current telehealth originating sites which qualify for
Medicare reimbursement, and would exempt them from the requirement that they are located in
a rural HPSA, MSA, or a demonstration project. This would remove a significant barrier to the
practice of telehealth in these originating sites, as it would allow for reimbursement of urban
critical access hospitals, sole community hospitals, home telehealth sites, and any originating
site in current law for the treatment of acute stroke.

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