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

[Catherine Britain]

Let's try the attachment one more time...

On Sun, Nov 1, 2009 at 10:42 AM, Catherine Britain <csbritain at gmail.com>wrote:

> 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
>



-- 
Catherine S. Britain
csbritain at gmail.com
541-910-7366
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