In December 2015, the Senate Finance Chronic Care Working Group developed a Policy Options paper as a precursor to legislation designed to address the needs of Medicare beneficiaries with multiple chronic conditions. Goals included improving quality of care in the home, streamlining care coordination, improving access to telehealth and remote patient monitoring services in alternative payment models such as ACOs and Medicare Advantage (MA) plans, and reducing Medicare costs. Subsequent to the options paper, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act has been introduced in the 115th Congress by both the House and Senate. Among other things, the bills address the need to adapt and expand supplemental benefits for MA plans to meet the needs of chronically ill MA enrollees, to eliminate barriers to care coordination among ACOs and to increase use of telehealth through supplemental benefits and waivers to current restrictions.
In comments on the Policy Options paper, AARC advocated for RTs to be included as part of the MA multi-disciplinary team and to include ACO waivers that would permit RTs to become telehealth providers. Later, AARC submitted comments on a draft of the CHRONIC Care Act highlighting RTs’ expertise as chronic disease managers and supporting their inclusion as telehealth providers. Last, AARC’s lobbyists met with key staff to push for inclusion of RTs as telehealth providers in legislative language and our PACT representatives did the same when they came to Washington in April 2017. Although RTs were not added to the CHRONC Care Act when it was reintroduced, there is a provision in the bill that could open the door for RTs in the future. The bill, if enacted, requires the Secretary to seek public comment no later than November 30, 2018, on expanding telehealth benefits in MA plans and whether practitioner licensure or specialized training should be considered in determining those who can furnish the telehealth services. Although any expansion of services and providers would be directed only to Medicare Advantage plans, it gives AARC an excellent opportunity to push for RTs to be included as telehealth providers. In the interim, AARC’s lobbyists will continue to pursue our goal of including RTs on the chance future amendments to the bill will be considered.