Mary Thompson is Executive Editor of Medtech Insight (E-mail: mary@medtechinsight.com)

SIDEBAR: Pushing for Reimbursement

The problem for physicians when it comes to remote monitoring is that they are not paid for the extra time they spend remotely managing patients. Although the remote follow-up is generally covered similar to an office visit, it is typically nurses that run these follow-up sessions. If there is a problem, the physician is called upon to review the data and the patient’s condition, and it is this physician time that is not currently reimbursed. Although a new set of reimbursement codes was developed by CMS two years ago, physicians are still waiting for Medicare and other payors to assign appropriate reimbursement.

In April, a bipartisan bill was introduced in the House of Representatives that would require Medicare to cover remote patient-management services associated with a number of chronic conditions, including heart failure and cardiac arrhythmia. The Medicare Remote Monitoring Access Act of 2008 has not yet made it out of the health subcommittee, and is likely to undergo significant changes before it does, but physicians and industry advocates remain hopeful. According to Bruce Wilkoff, MD, director of cardiac pacing and tachyarrhythmia devices at Cleveland Clinic in Ohio, who has long been an advocate of remote CRM patient monitoring, hope for the new House bill is particularly high because it emphasizes the positive impact that remote monitoring can have on patient safety and overall costs, two important issues facing Congress right now.

However, this is not the first time legislation such as this has been attempted. A similar bill was introduced in the Senate in 2007, and although that legislation failed to make it into last year’s Medicare funding package, a scaled-down version is still being worked on. Advocates would like to see remote-monitoring reimbursement included in the Medicare physician funding bill currently before Congress, although they admit it will be an uphill battle. Brett Loper, senior executive VP and director of government affairs for the Advanced Medical Technology Association (AdvaMed), which is working to get the remote monitoring bill through Congress, told Medtech Insight recently that it is always a challenge to get any new Medicare funding initiatives approved. However, the group is continuing to work with committee staff and the Congressional Budget Office (CBO) to refine the bill and still hopes to get something on remote monitoring included this year (one problem: the CBO says the current proposal isn’t budget neutral—but advocates are emphasizing the cost savings). Part of what’s currently on the table is a proposal to phase in or delay the start of the program, Loper said, but nothing at this point is set in stone. Meanwhile, "We’ve been successful at generating a great deal of interest in this issue," he said.

Sensing the State of the CRM Market

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