Recently, the American Congress agreed to a slightly amended version of the proposal introduced by Senator Kent Conrad on the telemedicine reimbursement for rural Health Personnel Shortage Areas (HPSAs). For the first time, the USA government has approved reimbursement of federal funds for regular, on-going medical consultations. Experts predict that the new legislation will yield 100 to 200 million dollar per year for telemedical health care delivery, starting from January 1st, 1999.
The American Telemedicine Association (ATA) has played an active role in obtaining support for Senator Conrad's proposal so that several elected representatives have changed their opinion in favour of the reimbursement legislation. As a consequence, provisions will be established for all eligible Medicare services from the Federal Supplementary Medical Insurance Trust Fund under part B at normal co-pay rates, excluding facility fees and transmission costs.
ATA President Jay Sanders considers the final approval as a major step in making telemedicine an integral part in the delivery of health care. Before this Congress decision, the American government already had granted a number of telemedical projects and supported several limited research initiatives on the effectiveness and efficacy of telemedicine. With the new legislation however, all American citizens receive a guaranteed access to medical care, regardless of their geographic location or socio-economic status, as Sanders states.
The Department of Health and Human Services (HHS) will actually start to make payments from January 1st, 1999, for professional consultations via telecommunications systems with a physician offering eligible services for patients residing in designated rural HPSAs. The funding has to be shared between the referring and the consulting care taker and may not exceed the current fee schedule for the medical services provided. At present, eligible areas are being identified by the Health Care Financing Administration in order to draft regulations concerning the implementations of the legislation.
Additionally, the Department of Health and Human Services will have to submit a report to Congress by January 1st, 1999 in which the use, quality and cost effectiveness of telemedicine will be assessed. The HHS Department will equally investigate possible expansion of telemedicine reimbursement for other potential beneficiaries. As it appears, telemedicine seems to have forced itself a way through the official barriers of Social Security in the USA.