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.
|