• Expand Medicare Reimbursement - Limited coverage for telemedicine delays the adoption of cost-saving and quality-improvement measures available through advanced technology and restricts consumer access and choice. Congress should extend Medicare reimbursement for remote medical and health services for: a) all remaining institutions eligible to participate in the Medicare but not currently eligible to be reimbursed for telemedicine/telehealth services, giving first priority to nursing homes, dialysis centers and community-based mental health centers; b) all remaining medical services currently covered under the CPT procedure codes but not eligible to be reimbursed when provided via telemedicine/telehealth, and c) medical services that are provided using store-and-forward technology, giving priority to dermatology and wound management.

• Encourage Home Telehealth and Disease Management - Home telehealth and disease management services have been proven to incur cost savings and improve care in homebound and chronic disease patient groups and have been singled out as a valued service by patients. However, these are not currently eligible for reimbursement under Medicare. Congress and CMS should encourage the use of home telehealth as a recognized and reimbursable component in the provision of home care under Medicare and provide reimbursement for the costs of deploying devices and related technology.

• Pass Remote Monitoring Bill - Patients should not be required to come into the doctor's office for routine, scheduled health monitoring appointments in cases where such services can easily and efficiently be provided in the patient's home or office. Additionally, the use of remote monitoring equipment allows providers to be aware of insidious changes in patient status long before costly complications result in symptoms that draw the attention of the patient. Medicare should change its reimbursement rules to allow existing patients to have their vital signs monitored remotely instead of traveling to their provider's office. Such services will add no federal expenditures and will significantly reduce costs for hospitalizations and emergency department visits. Consumers also benefit with improved health status and a reduction in the cost and inconvenience of traveling and taking time off work to make such appointments.

• Funding - ATA supports legislation that provides financial support for increased utilization of information services and technologies by healthcare institutions, especially the development and implementation of system-wide electronic patient records.

• Coordination - Congress and the Administration should encourage cooperation between newly funded health IT projects and existing telemedicine programs.

Existing federal and state laws can impede the growth of telemedicine and deny consumers and the health care industry access to its benefits.

• State Medical Licensure - ATA supports the full appropriation for authorization of the adoption of models that reduce restrictions in providing specialty consultations across state lines by state boards of licensure as described in the Safety Net Amendment of 2001. ATA will work with the National Association of State Medical Boards in securing support for the existing interstate licensure model. ATA will also work with national and regional governors and state legislative associations regarding mutual recognition of medical licenses.

• Nursing Interstate Compacts - ATA supports the efforts of the National Association of State Boards of Nursing to implement a nationwide set of mutual recognition laws within an interstate compact for the practice of nursing using telemedicine.

• Malpractice Coverage - State requirements to mandate payments for telemedicine service should be accompanied with requirements that insurance carriers provide malpractice coverage for those same services.

• Offsite Contracting - ATA supports the right of accredited U.S. medical institutions to contract with other organizations to provide medical services via telemedicine as long as appropriate provisions are included to: a) ensure that only qualified licensed personnel are used in providing the services, b) provide for ongoing quality assurance requirements within the contractual arrangement and c) assure that all patient confidentiality provisions are equally enforced by both the primary medical institution and the contractor.

• Resolve Internet Practice Issues - a) Email consultations between patient and physician should be reimbursed; b) No federal or state laws should prohibit the ability of telemedicine programs to provide prescription drugs to patients; c) ATA supports evaluating critical issues related to the availability of prescription drugs over the Internet including licensure laws, clinical practice deficits and consumer demand.

Public policy should support the use of telemedicine to help prepare and respond to large emergencies, whether caused by natural disaster or terrorist act. Such telecommunications connections can provide instant access to resources at the nation's tertiary care medical centers regardless of location.

• ATA will advocate for federal policies that support the integration and utilization of telemedicine in the design and development of preparedness and response networks and link public health and other emergency response networks with existing telemedicine systems.

• Federal emergency management regulations should be amended to integrate the practice of telemedicine within Federal Disaster Medical Assistance Teams.