She also looks forward to research exploring the role of telemedicine and where it best fits into practice, which would potentially include changing models for education of rheumatology fellows.
As noted in the statement, telemedicine should not replace essential face-to-face assessments conducted at medically appropriate intervals. Dr. Edgerton says it will be critical, moving forward, for rheumatology teams to integrate telehealth into the traditional in-person evaluation and management paradigm, ensuring that a comprehensive understanding of the patient and their needs continues to inform decision making.
Recommending Reimbursement Guidance
The position statement also includes an in-depth discussion of key issues associated with implementing telemedicine now and in the long term, including recommendations that address federal, state and regulatory structures, which have obstructed rheumatology telemedicine services in the past.
Changes during the current public health emergency have relaxed restrictions and allowed practices and providers to continue to provide care. Such changes include reimbursement for telemedicine services to allow 1:1 parity with in-person visits for both audio-only and audiovisual visits, as well as relaxation of HIPAA (Health Insurance Portability and Accountability Act) regulations to allow patients and providers to use more familiar or user-friendly platforms.
“While telemedicine’s rapid uptake has occurred due to necessity during the pandemic, we recognize it is likely here to stay, and the regulatory boundaries that are in place after the current public health emergency is over will dictate how useful this modality is to members and patients,” says Chris Phillips, MD, also a co-author of the position statement and chair of the CORC Insurance Subcommittee.
“We do advocate for ongoing audiovisual and audio-only parity. This is currently offered by CMS [the Centers for Medicare & Medicaid Services] and by most commercial payers and we would like to see it persist,” Dr. Phillips shares. However, telemedicine coding varies by payer. To address this challenge for providers and ease their administrative burden, the Telemedicine Position Statement recommends that private payers follow coding guidelines from the CMS.
“Through advocating for fair reimbursement, favorable regulatory guardrails, and outcomes-based research for telemedicine, we are promoting an environment that would allow rheumatologists and rheumatology health professionals to have access to telemedicine as a tool for patient care, going forward, that benefits both the provider and the patient,” Dr. Phillips says.
The Telemedicine Position Statement reflects broad input from members of the CORC, Government Affairs Committee and the ACR’s board of directors. The position statement will also be shared with members of Congress, insurance carriers, private insurers and state insurance commissioners.