hr 2291 heart act pg 1 2291... · eligible originating sites are currently limited to the...

Eligible originating sites are currently limited to the following:

© 2017 Public Health Institute Center for Connected Health Policy

CENTER FOR CONNECTED HEALTH POLICY

[email protected] | 877-707-7172

The Federally Designated National Telehealth Policy Resource Center

FACT SHEET

H.R. 2291HELPING EXPAND ACCESS TO RURAL TELEMEDICINE (HEART) ACT

SPONSOR: Rep Du�y (R-WI)

EFFECTIVE DATE: 6 months after the date of enactment

INTENT: To expand the coverage of telehealth services under the Medicare program, to provide coverage for home-based monitoring for congestive heart failure and chronic obstructive pulmonary disease under such program, and for other purposes.

CURRENT LAW

Allows store and forward for a critical access hospital, a sole community hospital or a rural health clinic (RHC).

Allows for reimbursement of “remote patient monitoring services” under certain circumstances. However RPM is de�ned separately from telehealth. See further description below.

H.R. 2291

Live video is eligible for reimbursement.

Store and forward is limited to demonstration projects in Alaska and Hawaii.

No reimbursement for RPM.

•

••

MODALITIES

GEOGRAPHICREQUIREMENTS

Requires that an originating site be located in a rural Health Professional Shortage Area (HPSA), non-Metropolitan Statistical Area (MSA), or Federal Demonstration project.

Exempts critical access hospitals and sole community hospitals from originating site geographic restrictions.

Amends allowance for sites located in a non-MSA, stating that it must be located in a county that is not both a county that has a population of greater than 70,000 individuals, according to the most recent decennial census and a county that is included in a MSA.

Must be administered by a physician or practitioner at a distant site, excluding RHCs and federally quali�ed health centers (FQHC) from the de�nition of a distant site.

ELIGIBLEDISTANTSITE

De�nes a distant site as including a rural health clinic. �e service would not be treated as a rural health clinic service.

ELIGIBLEORIGINATINGSITE

Provider o�ces;Hospitals;Critical access hospitals;

Adds a sole community hospital to de�nition of allowable originating sites.

May 2017


ELIGIBLETELEHEALTHPROFESSIONALS

Eligible telehealth professionals are currently limited to the following:

Eligible services limited to speci�c list of CPT codes established by CMS in physician fee schedule. Professional consultation, o�ce visits and o�ce psychiatry services are the only services required to be provided via telehealth in statute.

ELIGIBLESERVICES

Requires telehealth services to include respiratory services, audiology services, and outpatient therapy services (including physical, occupational and speech language pathology services).

PAGE 2

Rural health clinics;•

Federally quali�ed health centers;•Skilled nursing facilities;•Community mental health centers;•Hospital-based or critical access hospital-based renal dialysis centers.

•

Physicians;•Nurse practitioners;•Physician assistants;•Nurse midwives;•Clinical nurse specialist;•Clinical psychologists and clinical social workers (these professionals cannot bill for psychotherapy services that include medical evaluation and management services);

•

Adds “applicable professional” to providers able to be reimbursed through telehealth. Applicable provider includes:

Respiratory therapist;•

Audiologist;•Occupational therapist;•

Physical therapist; or•Speech language pathologist.•

Registered dietitians or nutrition professionals.

•

May 2017

HR 2291 would include applicable remote patient monitoring (RPM) services under the de�nition of “medical and other health services” and allow (but not require) payment for applicable RPM services for up to 90 days, at which point it could be renewed by the physician who provides chronic care management to the individual if the individual continues to qualify.

REMOTE PATIENT MONITORING SERVICES FOR CHRONIC CONDITIONS

DEFINITIONS

Applicable remote patient monitoring service - Remote patient monitoring services (de�ned below) furnished to provide for the monitoring, evaluation, and management of an individual with a covered chronic condition (de�ned below), insofar as such services are for the management of such chronic condition.

Remote patient monitoring services - Services furnished through remote patient monitoring technology.

PAGE 3

IMPACT & ANALYSIS

May 2017

Covered chronic health condition - Applicable condition when under chronic care management, de�ned in and applied under 1886(a)(5) (includes conditions selected by the Secretary under speci�c criteria for purposes of the Hospital Readmissions Reduction Program which includes congestive heart failure and chronic obstructive pulmonary disease).

Remote patient monitoring technology - A coordinated system that uses one or more home-based or mobile monitoring devices that automatically transmit vital sign data or information on activities of daily living and may include responses to assessment questions collected on the devices wirelessly or through a telecommunications connection to a server that complies with the Federal regulations (concerning the privacy of individually identi�able health information) promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996, as part of an established plan of care for that patient that includes the review and interpretation of that data by a health care professional.

HR 2291 would expand reimbursement for telehealth in several ways, allowing for more expansive reimbursement for store and forward, and opening up reimbursement for additional distant site providers, originating sites, and services. HR 2291 maintains Medicare’s geographic restriction (except for critical access hospitals and sole community hospitals), and the option for sites to qualify as a rural HPSA or federal demonstration project, however adds that if a site quali�es as a non-MSA it must also be located in a county that does not have a population of greater than 70,000 individuals. �is has the potential to disqualify some originating sites that previously quali�ed without the 70,000 individual restriction. CCHP is uncertain if this was the intent of the author.

HR 2291 would also allow for reimbursement for applicable remote patient monitoring services, although it is de�ned separately from telehealth. �is distinction allows RPM services to avoid the restrictions on telehealth services that currently exist in the Medicare program, however also further solidi�es the modality as di�erent from telehealth. �e bill only provides Medicare the ability to cover applicable RPM services, but does not require them to do so.

In determining the relative value of applicable remote patient monitoring services, the Secretary would be required to take into consideration physician or practitioner resources, practice expense cost and malpractice expense resources. �e Secretary must provide for separate payment for the service and cannot adjust the relative value units assigned to other services that might otherwise have been determined to include such separately paid remote patient monitoring services.

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Cyber Monday O�er!

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<p style="margin:20px 0 0 0; padding: 0;">It's <strong>Cyber Monday</strong> and Workplace Fairness now has some great cyber deals for you!</p>

<p style="margin:20px 0 0 0; padding: 0;"><strong>Workplace Fairness is the web's leading resource to get workers' rights information.</strong> Part of that means providing information about attorneys who represent workers. Last month, our website tra�c hit <strong>4 million users</strong> annually, and we are consistently at the <strong>top of Google's rankings</strong> for "�nd an employment lawyer" and "employment attorney directory ." Have you checked your WF attorney listing lately? <a href="http://www.workplacefairness.org/�nd-attorney" target="_blank">Go to our attorney listings</a> and search via state or zip code.</p>

<p style="margin:20px 0 0 0; padding: 0;"><strong>Buried in the listings or not happy with your placement?</strong> Workplace Fairness o�ers <a href="http://www.workplacefairness.org/free-employment-attorney-directory?link_id=2&can_id=c237030bc8276e5842caf92848386aa2&source=email-cyber-monday-deals-on-workplace-fairness-attorney-listings&email_referrer=cyber-monday-deals-on-workplace-fairness-attorney-listings&email_subject=cyber-monday-deals-on-workplace-fairness-attorney-listings" target="_blank">deluxe listing services</a> that can help your �rm reach even more clients. If you are not satis�ed with the free basic listing and want to appear more prominently, our deluxe listing services are right for you. We are now partnering with Avvo to provide even more attorney options for workers visiting our site, but our deluxe listings are always prioritized at the top of each search. Make sure you reach the millions of workers visiting our site—all for considerably less than what you could earn from just one new client.</p>

<p style="margin:20px 0 0 0; padding: 0;"><strong>Sign up today or tomorrow, and get the rest of 2016 free!</strong> If you make an appointment and sign up for a deluxe listing using the information below <strong>today or tomorrow only</strong>, your annual renewal will be in January 2018, with the rest of this year free of charge. For just $1000 annually, you've signi�cantly improved your marketing prospects now and throughout 2017.</p>

<p style="margin:20px 0 0 0; padding: 0;">By signing up by tomorrow, we will also apply the same discount to our other services, including <a href="http://www.workplacefairness.org/wfworks-2?link_id=3&can_id=c237030bc8276e5842caf92848386aa2&source=email-cyber-monday-deals-on-workplace-fairness-attorney-listings&email_referrer=cyber-monday-deals-on-workplace-fairness-attorney-listings&email_subject=cyber-monday-deals-on-workplace-fairness-attorney-listings" target="_blank">the web's best employment law content</a>, <a href="http://www.workplacefairness.org/wfworks-3?link_id=4&can_id=c237030bc8276e5842caf92848386aa2&source=email-cyber-monday-deals-on-workplace-fairness-attorney-listings&email_referrer=cyber-monday-deals-on-workplace-fairness-attorney-listings&email_subject=cyber-monday-deals-on-workplace-fairness-attorney-listings" target="_blank">websites for employment attorneys</a>, and targeted advertising and SEO services to also help you reach the best potential clients among the millions of visitors at our website.</p>

<p style="margin:20px 0 0 0; padding: 0;"><strong>Don't wait, sign up for your appointment today!</strong> To take advantage of our CyberMonday deal, please schedule your appointment at <a href="http://workplacefairness.appointy.com" target="_blank">http://workplacefairness.appointy.com</a>. You can also contact us at <strong>240-772-1205</strong> or email <a href="mailto:[email protected]" target="_blank">[email protected]</a> with your availability on Monday, November 28 or Tuesday, November 29.</p>

<p style="margin:20px 0 0 0; padding: 0;">We look forward to speaking with you!</p>

<p style="margin:20px 0 0 0; padding: 0;"><img src="http://workplacefairness.org/images/email/paula-signature.jpg" width="200" /></p><p style="margin:10px 0 0 0; padding: 0;">Paula Brantner<br />Senior Advisor, Workplace Fairness<br />240.772.1205 (o)<br />www.workplacefairness.org</p>


 </td> </tr> </tbody></table> </td> </tr> </table> </td> </tr> </table> </td> </tr> </table>  </td> </tr> <tr> <td align="center" valign="top" style="mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;">  <table border="0" cellpadding="0" cellspacing="0" width="100%" id="templateBody" style="border-collapse: collapse;mso-table-lspace: 0pt;mso-table-rspace: 0pt;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;background-color: #f9d635;border-top: 0;border-bottom: 0;"> <tr> <td align="center" valign="top" style="mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;"> <table border="0" cellpadding="0" cellspacing="0" width="620" class="templateContainer" style="border-collapse: collapse;mso-table-lspace: 0pt;mso-table-rspace: 0pt;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;"> <tr> <td valign="top" class="bodyContainer" style="padding-top: 9px;padding-bottom: 9px;mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;"><table border="0" cellpadding="0" cellspacing="0" width="100%" class="mcnTextBlock" style="min-width: 100%;border-collapse: collapse;mso-table-lspace: 0pt;mso-table-rspace: 0pt;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;"> <tbody class="mcnTextBlockOuter"> <tr> <td valign="top" class="mcnTextBlockInner" style="padding-top: 9px;mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;"> 


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Attorneys: Want to boost your online presence? </td> </tr> </tbody></table> 

 </td> </tr> </tbody></table><table border="0" cellpadding="0" cellspacing="0" width="100%" class="mcnTextBlock" style="min-width: 100%;border-collapse: collapse;mso-table-lspace: 0pt;mso-table-rspace: 0pt;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;"> <tbody class="mcnTextBlockOuter"> <tr> <td valign="top" class="mcnTextBlockInner" style="padding-top: 9px;mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;"> 


<td valign="top" class="mcnTextContent" style="padding-top: 0;padding-right: 9px;padding-bottom: 20px;padding-left: 9px;mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;word-break: break-word;color: #404040;font-family: Helvetica;font-size: 14px;line-height: 150%;text-align: left;">

<p style="margin: 10px 0;padding: 0;mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;color: #404040;font-family: Helvetica;font-size: 14px;line-height: 150%;text-align: left;">Lorem ipsum dolor sit amet, consectetur adipisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat.</p>

<p style="margin: 10px 0;padding: 0;mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;color: #404040;font-family: Helvetica;font-size: 14px;line-height: 150%;text-align: left;">With over 4 million people visiting our website each year to learn more about their rights, we help people needing lawyers all year long...and we want you to join us! With our <a href="#" style="mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;color: #1659ab;font-weight: normal;text-decoration: underline;">websites</a> and <a href="#" style="mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;color: #1659ab;font-weight: normal;text-decoration: underline;">web content</a> that highlight the most important issues representing workers and our <a href="#" style="mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;color: #1659ab;font-weight: normal;text-decoration: underline;">deluxe listings</a> and <a href="#" style="mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;color: #1659ab;font-weight: normal;text-decoration: underline;">advertising</a>, you can be ready for any season!</p>

<p style="margin: 10px 0;padding: 0;mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;color: #404040;font-family: Helvetica;font-size: 14px;line-height: 150%;text-align: left;">To learn more, contact us at <a href="mailto:info@workplacefairness" style="mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;color: #1659ab;font-weight: normal;text-decoration: underline;">info@workplacefairness</a> or <a href="tel:240-772-1205" target="_blank" value="+12407721205" style="mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;color: #1659ab;font-weight: normal;text-decoration: underline;">240-772-1205</a>.</p>


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<div style="text-align: center;">Copyright © 2016 Workplace Fairness, All rights reserved.<br><br>8121 Georgia Ave, Ste 600, Silver Spring, MD 20910 </div>


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