In addition to advocating for respiratory therapists as telehealth providers in legislation introduced in Congress as part of AARC’s overall legislative agenda, AARC is a member of a Telehealth and Remote Patient Monitoring Coalition (Coalition) that includes over 90 stakeholders from various health care and technology sectors supporting Medicare expansion of telehealth services and remote patient monitoring (RPM). The consensus among the group, based on an ever growing body of evidence, is items such as wireless health products, mobile medical device data, and telehealth screening and preventive services have shown to reduce hospitalizations, including hospital readmissions, improve patient health outcomes, and encourage patient engagement and self-management, especially among those who suffer from chronic conditions.
AARC often signs-on to joint Coalition comments in response to ongoing federal initiatives to support the expansion of telehealth and RPM activities. On several occasions AARC has joined the Coalition in encouraging the Centers for Medicare Services (CMS) to explore new and innovative connected health technologies or to pay separately for remote patient monitoring as part of the services that comprise CMS’ chronic care management program. For example, the Coalition was successful in getting CMS to pay separately for remote patient monitoring (CPT Code 99091) effective Jan. 1, 2018. Prior to that time, it was bundled into payment for chronic care management services. The Coalition was also instrumental in getting Congressional support to have the Agency for Healthcare Quality and Research conduct a technical brief of available scientific literature and studies to assist policymakers in assessing the applications and implications of telehealth interventions. Most recently, the Coalition supported coverage of three new remote patient monitoring codes that originated from the collaborative work of the American Medical Association’s Digital Medicine Payment Advisory group. As a result, CMS has proposed to activate and pay for further remote monitoring codes in its draft 2019 payment update to the Physician Fee Schedule, as well as to take steps to promote flexible use of remote monitoring innovations in the Quality Payment Program.
With respect to Medicare, we know that a legislative change is needed to permit respiratory therapists to furnish telehealth services. However, based on Coalition comments that included AARC, improvement has been made in providing flexibility to some of the alternative payment models such as Accountable Care Organizations and Medicare Advantage plans to permit certain waivers and additional supplemental benefits that may include telehealth. Comments from the Coalition specifically suggested waivers that would permit respiratory therapists and other allied health professionals such as physical therapists, occupational therapists, etc., to furnish telehealth services; however, CMS noted that those who furnish services would still need to meet the definition of a Medicare provider which would preclude RTs from participating. Over time, our work as part of the Coalition may bring about additional changes. Regardless, AARC remains committed to expanding telehealth services that can benefit respiratory patients and the advancement of telehealth services in general.