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 Frequently Asked Questions
 

Answers to the following frequently asked questions are available below:

If you have a question not addressed above, please feel free to contact Gary Capistrant, Senior Director of Public Policy for the American Telemedicine Association at 202-223-3333 or gcapistrant@americantelemed.org.


What is the Medicare barrier for urban beneficiaries to telehealth?

A big restriction in Medicare’s coverage of telehealth is the lack of coverage for metropolitan areas.  Thus, 79% of Medicare’s beneficiaries are blocked from accessing these cost effective, vital health services.  The current law essentially states that a beneficiary must be served at site located “in a county that is not included in a Metropolitan Statistical Area.”  This bars reimbursement in all but the most rural parts of America.

Every state has at least one SMSA (Standard Metropolitan Statistical Area); New Jersey, Rhode Island and the District of Columbia are totally in one or more SMSA.  Also, many Congressional Districts are totally in one or more SMSA. In the U.S., there are 363 SMSAs, encompassing 1092 counties, ranging in population from Carson City, Nevada SMSA with about 55,000 on up.  Below is a state-by-state listing of the showing the number and percentage of beneficiaries living in an SMSA.

Many small population counties are caught in the SMSA definition.  There are 53 counties with a population of less than 10,000 (according to the 2000 census), 238 counties with less than 25,000 and 504 with less than 75,000.

Problems of access to care are just as bad, though often different, in metropolitan areas, such as in HHS –identified health professional shortage areas, medically underserved areas, or medically underserved populations.

             MEDICARE  BENEFICIARIES

Total

Metro

% Metro

Alabama

778,487

520,254

66.8%

Alaska

56,668

35,731

63.1%

Arizona

836,298

761,099

91.0%

Arkansas

494,242

257,149

52.0%

California

4,365,487

4,208,607

96.4%

Colorado

555,006

460,755

83.0%

Connecticut

536,260

487,838

91.0%

Delaware

134,793

95,055

70.5%

District of Columbia

74,112

74,112

100.0%

Florida

3,128,524

2,897,134

92.6%

Georgia

1,104,846

811,945

73.5%

Hawaii

188,856

135,607

71.8%

Idaho

204,939

125,639

61.3%

Illinois

1,738,361

1,419,208

81.6%

Indiana

937,175

699,012

74.6%

Iowa

498,863

234,990

47.1%

Kansas

410,409

232,355

56.6%

Kentucky

708,073

356,491

50.3%

Louisiana

635,618

449,930

70.8%

Maine

245,497

131,569

53.6%

Maryland

722,297

670,065

92.8%

Massachusetts

996,574

992,517

99.6%

Michigan

1,538,231

1,183,522

76.9%

Minnesota

727,938

462,950

63.6%

Mississippi

467,152

178,438

38.2%

Missouri

943,179

637,802

67.6%

Montana

155,126

50,910

32.8%

Nebraska

266,962

124,340

46.6%

Nevada

316,606

272,396

86.0%

New Hampshire

197,493

109,740

55.6%

New Jersey

1,258,034

1,258,034

100.0%

New Mexico

283,200

172,990

61.1%

New York

2,846,997

2,567,918

90.2%

North Carolina

1,346,786

850,400

63.1%

North Dakota

104,905

38,665

36.9%

Ohio

1,800,830

1,427,370

79.3%

Oklahoma

563,034

321,392

57.1%

Oregon

564,349

393,761

69.8%

Pennsylvania

2,181,408

1,797,324

82.4%

Rhode Island

175,132

175,132

100.0%

South Carolina

690,280

498,660

72.2%

South Dakota

128,509

49,630

38.6%

Tennessee

968,131

645,793

66.7%

Texas

2,690,229

2,162,741

80.4%

Utah

252,572

214,694

85.0%

Vermont

101,272

26,884

26.5%

Virginia

1,041,847

807,533

77.5%

Washington

869,583

720,137

82.8%

West Virginia

366,366

187,435

51.2%

Wisconsin

852,893

568,893

66.7%

Wyoming

73,879

22,781

30.8%

United States

43,124,308

33,985,327

78.8%

Why are non-physician providers, such as Speech-Pathologists, Audiologists, Physical and Occupational Therapists, included in this petition?

We urge Congress to extend Medicare telehealth eligibility to Audiologists, Speech-Language Pathologists, Physical and Occupational Therapists and other non-physician providers who are approved Medicare providers. 

Telehealth gives Medicare beneficiaries increased access to rehabilitation. For example, a patient recovering from a stroke or other illness may have difficulty traveling to a  medical facility for treatment. Instead, telehealth could allow them to receive services at home or at a nearby satellite clinic.  Telehealth would also give Medicare beneficiaries greater access to specialists in a particular area of rehabilitation.

Current Medicare law specifies only certain Medicare providers from whom beneficiaries can get covered telehealth care.

How would the Medicare principles affect the availibility of rehabilitation services to Medicare beneficiaries?

Telehealth services by speech-language pathologists, audiologists, and other non-physician providers could be offered by hospitals, skilled nursing facilities, outpatient clinics, private practitioners, and home health agencies. Through the use of technology, clinicians can provide services that are equivalent to face-to-face treatment. Telehealth can offer a solution to personnel shortages in urban and rural challenging areas by increasing facilitating to providers at a greater distance.

What are the benefits of Telehelath?

Please review Outcomes.pdf for more information.

How can I get the text and current status of the Congressional bills?

Go to http://thomas.loc.gov and under Legislation in Current Congress, Search Bill Summary & Status enter the bill number and click on the Bill Number search option.


 

 
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