Senate advances telemedicine payments

State lawmakers aren’t sure whether they will expand Medicaid coverage, but if they do, they support at least one new tool to help health care providers care for the expected influx of new patients: telemedicine.

The Indiana Senate voted unanimously last week to require the Indiana Medicaid program to pay home health agencies, rural health clinics and federally qualified health centers for doing medical consultations, diagnoses and monitoring using videoconferencing, telephones or computers.

The move could open up greater access to specialist physicians, especially psychiatrists, in medically underserved areas, Kathy Norris, a fiscal analyst at the Legislative Services Agency, noted in a report on the bill. And it could save the state money, if it no longer has to pay for as much travel by health care providers to reach far-flung patients, Norris added.

While nearly every other industry has engaged in more communication at a distance in the past decade, health care has not made that transition because doctors are typically paid only when they see patients face to face.

“The technology is there. But reimbursement is lagging behind,” said Don Kelso, executive director of the Indiana Rural Health Association.

Mike Ripley, a lobbyist for the Indiana Chamber of Commerce, said his organization favors the bill because it could help the state deal with a rising number of patients.

“With an increasing demand on primary physician services, this provides a cost-effective means of providing services to the Medicaid population,” Ripley wrote in a legislative update on Friday.

President Obama’s 2010 Patient Protection and Affordable Care Act called for all states to expand their Medicaid programs for the poor by raising eligibility to all adults earning up to 138 percent of the federal poverty limit.

In Indiana, such an expansion would bring in more than 400,000 new people, according to estimates by Milliman Inc., the Seattle-based actuarial firm hired by the state.

Since consumers with insurance tend to use about twice as much health care services as those without insurance, the Medicaid expansion is expected to strain the ability of doctors, nurses and hospitals to care for the newly insured patients.

The measure, Senate Bill 554, is co-authored by Sen. Vaneta Becker, R-Evansville; Sen. Jean Leising, R-Oldenburg; and Sen. Jean Breaux, D-Indianapolis.

Also last week, the Senate passed Senate Bill 551, which instructs the state government to seek a federal block grant to expand Medicaid coverage via the Healthy Indiana Plan or a program similar to it. It is unclear if the Obama administration will OK such a grant.