The US Department of Veterans Affairs (VA) would like to remove barriers to telehealth and allow its providers—including physical therapists (PTs)—to conduct telehealth activities across all 50 states and in non-federal sites, including patients’ and providers’ homes.
In a proposed rule, the VA describes how its current telehealth program is limited by many state professional licensure laws and regulations, which restrict telehealth activities to within state borders. Additionally, writes the VA, many VA medical centers only allow telehealth on federal property out of concern that its providers will run afoul of state regulations, thereby eliminating the possibility of a patient receiving telehealth at home.
Medicare could become a much more welcoming place for telehealth services if Congress passes 2 pieces of legislation recently introduced in the US House of Representatives. The 2 separate bills would have the combined effect of expanding where and how telehealth services can take place, which patients are permitted to receive the services, and the list of health care professional who can provide the services—a list that includes physical therapists (PTs).
The bills—1 called the Medicare Telehealth Parity Act, and a second known as the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act—propose changes to the way Medicare handles a number of issues, from remote monitoring of patients with chronic conditions, to a reworked definition of reimbursable telehealth codes. In addition, the parity act expands the list of providers who can provide telehealth services to PTs, respiratory therapists, occupational therapists (OTs), speech language pathologists, and audiologists, while the CONNECT act would allow PTs in some bundled payment arrangements, accountable care organizations (ACOs), and Medicare Advantage plans to participate in telehealth arrangements.
Over the last decade, virtually every aspect of health care has been affected by technology in some way. From electronic health records to telehealth, from wearable devices to apps that let you make appointments and refill prescriptions with a few taps, technology has made the delivery of health care more efficient and more effective.
One area that is changing drastically due to technology is physical therapy. While it might seem like some of the innovations in PT are something out of a science fiction movie, they are very real — and making a very real difference in patients’ lives, especially when it comes to reduced healing times and more comfortable care. Technology is allowing physical therapists to deliver better care than ever before, and leading to new advancements beyond what anyone imagined.
A recent small-scale study of veterans is adding support to the idea that the more people are exposed to telehealth—this time in the form of postoperative care—the more they like it.
In a research letter published in the September 23 edition of JAMA Surgery, authors share the results of a survey of 35 veterans receiving both in-person and telehealth-based postoperative care for “low complexity” surgeries including gall bladder removal, hernia repair, appendectomy (laproscopic), thyroid removal, or soft tissue excision. Authors of the letter described these surgeries as “amenable to postoperative telehealth evaluation.”
After discharge, the veterans received 3 sequential follow-up visits: 1 by telephone, 1 in person, and 1 via videoconferencing that followed a standard rubric addressing general recovery, follow-up needs, wound care needs, and complications.
Delaware physical therapists (PTs) have a new scope of practice that includes telehealth, dry needling, and an updated definition of the practice of physical therapy now that a significantly revised PT licensing law has been signed by Gov Jack Markell. Markell signed the bill on August 12.
Advocated for by the Delaware Physical Therapy Association, the legislation (HB 359) faced opposition from other provider groups, including acupuncturists who were opposed to the inclusion of dry needling in the new definition for physical therapy. In addition to the dry needling and telehealth provisions, the new law includes temporary exemptions to licensure for PTs licensed in another state who are in Delaware for educational purposes, accompanying travelling sports team or performance groups, or responding to declared emergencies.
A newly introduced bill aimed at expanding the use of telemedicine in the Medicare system would allow reimbursable telehealth services for physical therapy and permit use of the technology in more populated areas.
Called the Medicare Telehealth Parity Act of 2014, the bill introduced by Reps Mike Thompson (D-CA) and Gregg Harper (R-MI) would gradually roll out changes over 4 years. The changes would eventually remove current limits on the population areas that qualify for Medicare’s telehealth reimbursements, allow for much-expanded remote patient monitoring, and include rural health clinics as approved telehealth care sites.
Another important feature of the bill: a provision that outpatient therapy services, including physical therapy, delivered via telehealth technologies would be reimbursable under Medicare.