Legislation Increased Medicare Telestroke Billing, But Underbilling And Erroneous Billing Remain Common.

Legislation Increased Medicare Telestroke Billing, But Underbilling And Erroneous Billing Remain Common.
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DOI:
10.1377/hlthaff.2021.00791
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发表时间:
2022-03
期刊:
影响因子:
9.7
通讯作者:
Mehrotra, Ateev
Mehrotra, Ateev
中科院分区:
医学1区
文献类型:
--
作者:
Wilcock, Andrew D.;Schwamm, Lee H.;Zubizarreta, Jose R.;Zachrison, Kori S.;Uscher-Pines, Lori;Majersik, Jennifer J.;Richard, Jessica, V;Mehrotra, Ateev

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在2018年的FAST法案中,国会永久性地将急性中风(远程中风)远程医疗咨询的医疗保险支付从仅在农村地区提供扩大到城市和农村地区,从2019年1月起生效。使用受控的时间序列分析,我们发现,在FAST法案实施一年后,直接受影响的城市医院和间接受影响的乡村医院的急诊科的医疗保险远程中风费用大幅增加。然而,在FAST法案实施一年后,只有少数已知具有远程中风能力的医院曾为该服务向联邦医疗保险开具账单,而且有大量与联邦医疗保险要求不符的账单。随着国会考虑大流行后医疗保险远程医疗支付的选择,我们的发现--与提供商对远程医疗账单要求的困惑一致--表明简化的支付规则将有助于确保扩大报销范围达到预期的效果。
In the FAST Act of 2018, Congress permanently expanded Medicare payment for telemedicine consultations for acute stroke (“telestroke”) from delivery only in rural areas to both urban and rural areas, effective January 2019. Using a controlled time-series analysis, we find that one year after FAST Act implementation, billing for Medicare telestroke increased substantially in Emergency Departments at both directly-affected urban hospitals and indirectly-affected rural hospitals. Nevertheless, one year after FAST Act implementation, only a minority of hospitals with known telestroke capacity had ever billed Medicare for that service and there was substantial billing inconsistent with Medicare requirements. As Congress considers options for post-pandemic Medicare telemedicine payment, our findings--consistent with provider confusion regarding telemedicine billing requirements--suggest simplified payment rules would help ensure expanded reimbursement achieves its intended impact.
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