97 Counties to Lose Telehealth Medicare Benefits

97 Counties to Lose Telehealth Medicare Benefits

Medicare beneficiaries in 97 counties—across 36 states and territories—are slated to lose telehealth benefits because of updated federal delineations of Standards Metropolitan Statistical Areas. The American Telemedicine Association urges Congress to amend federal statute and ensure that existing beneficiaries will not lose coverage for these life-saving services. 

 

Medicare beneficiaries in 97 counties—across 36 states and territories—are slated to lose telehealth benefits because of updated federal delineations of Standards Metropolitan Statistical Areas (SMSAs). The new federal urban/rural categorization effectively revokes the option for Medicare recipients to receive healthcare services via videoconferencing—one of the most common and cost-effective forms of telehealth. Hundreds of thousands of beneficiaries are negatively impacted by this statistical realignment. Medicare coverage is not available for video visits to beneficiaries living in metropolitan areas–where over 80% of recipients live.

The new SMSA rules designate 28 additional counties as “non-metropolitan,” qualifying their residents for telemedicine services under Medicare. However, the same adjustments increase the total number of counties, population and patient base that are precluded from the benefits of telemedicine.

”When it comes to telemedicine, Congress has long overlooked the need for telemedicine services to residents of urban counties, despite the fact that they often suffer similar problems accessing healthcare. Now, because of a statistical quirk, even more people will lose coverage of these services, reducing access and care,” said Jonathan Linkous, CEO of the American Telemedicine Association. “Medicare should cover remote health services for all beneficiaries, regardless of location. We call on Congress to ensure that existing beneficiaries will not lose coverage for these services.”

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