Senate Finance Committee Chair Orrin Hatch, R-Utah, introduced the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016 (S. 3504) on Dec. 6, which includes a section that would expand the ability of Medicare beneficiaries on home dialysis to receive required monthly clinical assessments using telehealth, beginning in 2018.
Currently, home dialysis patients can use telehealth to receive a monthly clinical assessment only if it occurs in an authorized originating site (including a physician office and hospital-based dialysis facility) and the site is located in a rural Health Professional Shortage Area or area county outside a Metropolitan Statistical Area.
The CHRONIC Act expands the number of originating sites for monthly clinical assessments to include freestanding dialysis facilities and the patient’s home, and lifts the geographic restrictions. The bill also specifies that Medicare would not provide a separate payment for the originating site fee if the service is furnished in the home.
Home dialysis patients would be required to have a face-to-face assessment with a nephrologist at least once every three months. The 2016 Medicare Fee Schedule (MFS) added home dialysis to the category 1 telehealth list, but did not designate the home as an approved originating site.
“Since the home is not an approved site, the options for seeing home dialysis patients by telehealth are limited,” Renal Physicians Association President Rebecca J. Schmidt, DO, told NN&I after the MFS was released.
The bill was created by the Senate Finance Committee Chronic Care Working Group, which was formed in May 2015 to explore cost-effective solutions to improve health outcomes for Medicare patients living with one or more chronic conditions. Read more on the bill here.