[ORTCCTelehealth-TAO] H.R. 3962 Telehealth Provisions

[Catherine Britain]

Good Morning,

I hope this finds you all well on this first day of November.  I just
returned from a Northwest Telehealth Resource Center Board of Directors
Meeting in Billings MT. During the meeting we received a briefing from Jon
Linkous and staff at the ATA regarding the telehealth provisions of H.R.
3962, the House's combined versions of Health Care Reform.  I have attached
a summary of the these provisions to this message.
There are two important provisions missing from this bill:
1.  The CMS distinction between urban and rural has not been removed.  The
reason for this is because the Congressional Budget Office attached a $100M
price tag to this provision.  Since none of the provisions in the reform
package are supposed to raise healthcare costs, this provision was not
included.

2.  There is no privileging by proxy included in the bill.  The bill does
allow hospitals to accept credentialling packages for providers from
hospitals under CMS, but hospitals must continue their own privileging
processes.  The concern here is not for hospitals as much as for physicians
and practitioners.  Privileging must be included in every physician's
record, and it remains in the record for as long as the physician
practices.  When a physician practices telemedically, he must be privileged
at every hospital receiving services from him telemedically.  If a physician
moves or if a service is no longer needed at a hospital, or if a physician
decides that the cost of maintaining privileges is too high (say he sees
only 2 patients per year and pays $1K for privileges), his record will show
a loss of privileges at that hospital.  A lot of activity on his record may
cause payers, malpractice insurers and other hospitals seeking to hire him
to question his privileging record.  This creates alot of extra work and
documentation for practitioners, and they risk of loss of insurance or
potential practice opportunities.  As a result, some physicians are no
longer willing to practice telemedically.

A combined version of the Senate bills is in the works but none of the
telehealth provisions are the same as those in the House bill which might
actually help when both bills finally reach Conference Committee.

Our advocates in Washington are continuing to work long and hard to see that
the provisions remain in the bill and to find some way to get others added.
There is always the option to carry forward separate legislation for
telemedicine, but it will be much more difficult to get passed than if it is
included in the reform packages.  I'll try to keep you posted in this fast
changing environment.  Please let me know if you have questions or comments
that can be forwarded either to ATA or TLI.

Remember democracy is not a spectator sport, and much is at stake for the
future of telemedicine in Oregon.

Kind regards,
Cathy
-- 
Catherine S. Britain
csbritain at gmail.com
541-910-7366
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