Questions Arise Over Medicare Coverage for Mental Health Services by Telehealth

A sentence tucked into last year’s pandemic relief bill sets requirements for in-person care before Medicare will cover mental healthcare services via telehealth.

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Lawmakers Reintroduce Post-COVID-19 Telehealth Bill, Hoping for a Better Outcome

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The Protecting Access to Post-COVID-19 Telehealth Act is back, after failing to make it through Congress last year. Will lawmakers see enough value in telehealth to make it a priority this year?

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Americans who received swine flu vaccines are at risk for paralysis disorders

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The federal government has once again been exposed for lying about the safety of the infamous swine flu vaccine, also known as H1N1. According to a new study published in the journal The Lancet, people who received the swine flu vaccine during the 2009-2010 pandemic hoax were at an elevated risk of developing a potentially-deadly paralysis disorder known as Guillain-Barre syndrome, or GBS. Continue reading

A Revealing Look at Knee Replacement

We don’t often talk surgery at Doctors Health Press, but when there are huge population trends, it’s helpful to know what is going on all around us. Here’s a story on the upswing of total knee replacement surgery in the U.S. and what this thing is all about.

It is a very common, safe surgery used to relieve severe pain and disability caused by knee osteoarthritis, thus improving quality of life. While common, Continue reading

Heart Failure Hospitalizations on the Decline

Here is a study to sink your teeth into. The nationwide rate of being hospitalized for heart failure is on the decline. A major new study has found the positive health news, and it is well worth sharing. Continue reading

Brutal Medical Radiation

With radiation levels increasing across the entire northern hemisphere the radiation your doctor uses takes on a new dangerous meaning. Physicians know that radiation is dangerous but they cannot help themselves, they love to use radiation both in testing and in treatment. Modifying physician behavior is hard thing to do but we have to do it and do it now in the radiation departments. How doctors and hospitals relate to and use radiation in both diagnosis and treatment of disease needs to come under full review and in most cases be brought to a halt.

Modifying physician behavior is hard thing to do but we have to do it and do it now in the radiation departments. How doctors and hospitals relate to and use radiation in both diagnosis and treatment of disease needs to come under full review and in most cases be brought to a halt. Continue reading

CMS Rule Eases Authorization Requirements for Telehealth

The Centers for Medicare & Medicaid Services today issued a final rule implementing changes to the Medicare Conditions of Participation for the credentialing and privileging of telemedicine physicians and practitioners. The Medicare CoPs previously required the governing body of a hospital to make all privileging decisions based on the recommendation of the hospital’s medical staff after the medical staff had thoroughly reviewed the credentials of practitioners applying for privileges. Similarly, each critical access hospital was required to have its privileging decisions made by its governing body or the individual responsible for the CAH. This requirement was applied regardless of whether the services are to be provided onsite at the hospital or through a telecommunications system. Today’s final rule allows the hospital or CAH receiving the telemedicine services to  Continue reading

Telemedicine Finally Taking off in Rural Areas

The National Broadband Network, with its promised high speeds, is still a long way off, but already thousands of patients in rural and remote Australia are using slower broadband for their day to day healthcare needs.

Doctors and clinicians are eagerly awaiting the NBN, but telehealth experts are already trialing new technology that will save not just money but lives.

This is health care in the not too distant future, but the tools will be familiar to many tech savvy households – high definition television, video conferencing and the latest iPad. Continue reading

Impact of the New Health Law on the Digital Health Industry

This month’s newsletter is part 2 of a three-part series examining the new healthcare law’s impact on the technology sector. This month, we focus on the health insurer side. In the final Issue, we will look into the medical device industry to analyze its exposure and upside under the new health law.

The Patient Protection and Affordable Care Act (“Affordable Care Act”), passed in the spring of 2010, has some favorable provisions for health insurers. The law, after its full enactment in 2014, will require near universal coverage,  Continue reading

More Medicare, Medicaid Patients Turning to Alternative Therapies.

The use of complementary and alternative medicine (CAM) is increasing in the United States. According to the National Center for Complementary and Alternative Medicine (NCCAM), about 38% of adults in the US used some form of CAM in 2007. Most of those are women with higher levels of education and income, however it appears that more patients on government healthcare plans, such as Medicare and Medicaid, are also using CAM due to frustration with access to standard healthcare.

NCCAM defines CAM as a “group of diverse medical and health care systems, practices, and products that are not generally considered to be part of conventional medicine.” Therapies include acupuncture, biofeedback, chiropractic care, diet and nutrition-based therapies, homeopathic treatment, hypnosis, massage, naturopathy, and exercises such as yoga and tai chi.

Most health insurance plans does not cover CAM, including Medicare and Medicaid, and patients must pay out of pocket. Naturopathic doctors, for example, are not eligible to be Medicare or Medicaid providers and have to charge patients “fee for service.” Even plans that offer coverage usually do so at a higher deductible cost than conventional care. Usually this is a deterrent for patients who have budget restraints.

However, budget cuts have caused a reduction in services for many Medicaid patients and due to low reimbursement rates, many doctors are opting out of the Medicare program. These patients are forced to seek care elsewhere or try other options. For example, a survey by Flexcin International of Fort Myers, Florida, a company that makes an all-natural arthritis supplement, found that in states where significant Medicaid cuts were occurring, patients were increasing their use of their over-the-counter product.

Read: HAP Medicare Advantage Options Include Acupuncture, Chiropractic Care

Chiropractic care is one area of complementary medicine that is gaining coverage under some health plans, including Medicare, although such coverage is usually limited. Plans either put a limit on the number of treatments one can receive or limit the procedures that are covered. Medicare, for example, will only cover manual manipulation for subluxation of the spine.

Acupuncture is another area that is increasingly gaining coverage due to the greater number of solid medical evidence that it is able to treat certain conditions and symptoms. Medicare specifically excludes treatment by acupuncture. Those states that provide coverage under their Medicaid program limit the benefits or require that coverage be provided only for treatments by a licensed physician (MD or DO).

Health insurance rarely covers the costs of other types of CAM therapies, so these become out of pocket expenses. However, some patients view a $10 bottle of nutritional supplements as preferable to a $25 physician co-pay plus the cost of a prescription, particularly when access to supplements is easier than finding a doctor who will accept a government health plan. Unfortunately, alternative medicine (that which is used instead of conventional medicine instead of as a complementary therapy) can, in some cases, be dangerous.

Read: Medicare Out of Pocket Expenses

The National Institutes of Health offer seniors and other Americans information on choosing complementary and alternative therapies wisely. Most important is to be an informed consumer. Learn the facts about CAM therapies, including the potential risks. It is wise to present your primary care physician with a list of all of your health conditions and current medications and speak to him or her about the addition of a CAM therapy. Include a discussion of budget restraints or frustrations with healthcare access to find the group of treatments that is best for you.

Telemedicine Acknowledged by Medicare

American Medical News: Through teleconferencing technology, doctors are able to treat patients who live far away without access to a specialist. “Nationwide, telemedicine increasingly is being used to bridge gaps in access to care in rural and other medically underserved communities that have a hard time recruiting physicians. … The Centers for Medicare & Medicaid Services is making changes to promote telemedicine. In June, the agency proposed new policies that would make it easier for hospital officials to credential physicians who provide telemedicine services at their facilities. And in January 2011, CMS will expand Medicaid coverage for remote services, including disease management training for patients with diabetes or kidney disease” (Krupa, 11/22).

Austin American-Statesman: “Tech executives say Austin is positioned to be a player in health care technology, thanks to its deep pool of business software talent that is comfortable working in a startup environment and has expertise in creating products that save companies money. … So far, a handful of promising venture-backed players have emerged. … All in all, hundreds of computer hardware, software and services companies are competing for a piece of the market, which accelerated in 2009 with the passage of the federal economic stimulus bill, which set aside $19 billion in incentives for health care information technology. By one estimate, the government’s push to spur health care computer spending will help drive global health care IT spending to $106 billion by 2014, up from nearly $89 billion this year (Hawkins, 11/21).

The (Newark, N.J.) Star-Ledger: “Under federal health care reform, doctors must convert to an electronic system capable of chronicling each patient visit, tracking their care and sharing that information with hospitals and other doctors by 2015 — or the federal government will withhold some of the money it reimburses them for treating Medicare and Medicaid patients. … But so far, neither the promise of incentive nor threat of punishment is enticing a large number of New Jersey doctors to make the big switch. Only 20 percent of physicians in New Jersey have incorporated electronic medical records into their daily practice, compared to nearly 30 percent nationally, state Health and Senior Services Commissioner Poonam Alaigh said” (Livio, 11/21).

Medicare Expands Coverage To Help Smokers Quit

They’ve lived with the health warnings about smoking for much of their lives and doubtless seen the ill effects on friends, relatives and even themselves, yet about 4.5 million older people in the U.S. keep on lighting up. Medicare is finally catching up to most private insurers by providing counseling for anyone on the program who’s trying to kick the habit.

Dr. Barry Straube, Medicare’s chief medical officer, says it’s never too late to quit, even for lifelong smokers.

“The elderly can respond to smoking cessation counseling even if they have been smoking for 30 years or more,” says Straube. “We do know we can see a reduction in the death rate and complications from smoking-related illnesses.” Not only cancer, heart disease and lung problems, which can kill, but also gastric reflux, osteoporosis and other ailments that undermine quality of life.

Smoking-related illnesses cost Medicare tens of billions a year. Straube cites a two-decade estimate of $800 billion, from 1995 through 2015.

Medicare already covers drugs used to help smokers quit, as well as counseling for those who have developed a smoking-related illness. But starting immediately, the program will expand the benefit to cover up to eight counseling sessions a year for people who want to quit.

Next year, such counseling will be free, under a provision in President Barack Obama’s health care law that eliminates co-payments for preventive services.

Older smokers often don’t get as much attention from doctors as do younger ones. “They just figure, ‘Well, it’s too late,'” said Straube, that the damage is already done. That may start to change now.

About one in 10 seniors smoke, compared with one in five people among the U.S. population as a whole. It turns out that smokers age 65 and older present a medical paradox.

Many started when it was fashionable to light up. They are more likely than younger smokers to be seriously hooked on nicotine and less likely to attempt quitting. But research shows that their odds of success are greater if they do try to give up the habit.

Older smokers who receive counseling are significantly more likely to quit than those who only get standard medical care. One study of elderly heart attack patients found that those who got counseling to help quit smoking were more likely to be alive five years later.

It’s unclear why older people who try to quit have better luck than younger smokers.

Some experts think it’s because older smokers are more motivated, perhaps from having seen a loved one die of cancer or heart disease, or by recognizing how the cigarette habit has left its mark in their own bodies, anything from wrinklier skin to shortness of breath.

Straube has his own theory: “They’re under less stress,” he said. “They are not working anymore, and they have more time.”

Medicare’s new smoking cessation benefit will also be available to younger people who are covered by the program because of a disability. About 1 million of them are smokers.