RemoteICU sues HHS for not reimbursing for telehealth provided by physicians outside of the country

RemoteICU, a telemedicine supplier team, is suing the Division of Overall health and Human Companies and the Centers for Medicare and Medicaid Companies for not reimbursing telehealth services presented by physicians who are located exterior the United States, according to a federal lawsuit filed past week in Washington D.C.

RICU desires reimbursement for telehealth services presented in just the U.S. but not necessarily by a doctor who lives in just its borders.

The business employs physicians who dwell exterior the nation but who are U.S. board-accredited vital-treatment professionals and are certified in one or more U.S. jurisdictions. With RICU’s telecommunications system, these physicians can deliver vital treatment services in U.S. medical center ICUs, the lawsuit stated.

“Even though RICU’s physicians dwell overseas, they provide as whole-time, permanent team customers of the U.S. hospitals at which they provide clients,” the business stated in the court docket filing. “By employing U.S.-certified intensivists who dwell overseas, RICU has enabled the American healthcare system to recapture expertise that would otherwise be lost to it – and this has aided to relieve the ongoing lack of intensivists in American hospitals.”

When CMS expanded the listing of telehealth services for which it reimbursed in December 2020 to include things like vital treatment services, RICU commenced providing its physicians to hospitals that couldn’t afford to pay for ICU telehealth without Medicare reimbursement, the court docket filing stated.

Even so, immediately after the business attained out to a number of officials from HHS and CMS, it was notified that Medicare could not reimburse the client hospitals for RICU’s services mainly because the Medicare Act “prohibits Medicare payment for services that are not furnished in just the United States,” according to the filing.

The business is looking for a preliminary injunction to cease HHS and CMS from denying Medicare reimbursement for telehealth services on the foundation of a provider’s actual physical site exterior of the United States at the time of support.

What’s THE Effects

RICU claims that by not reimbursing for the vital treatment telehealth services presented by its physicians, HHS and CMS are resulting in “rapid damage both of those to RICU and to the public.”

It argues that it is really filling a hole in vital treatment that has been exacerbated by the pandemic.

“There remains [a] major unmet will need for vital treatment services, as desperately ill clients have overcome ICU methods across the nation,” RICU stated in the court docket filing. “In some conditions, lack of enough treatment can signify the variation between existence or death. And one of the groups most at chance from death and significant illness thanks to COVID-19 is the aged – the very identical populace that relies on Medicare.”

With no reimbursement, RICU says that some of its existing clientele, as properly as probable consumers, will not be capable to provide its services.

The business argues that this brings about “major, unrecoverable financial damages” mainly because tele-ICU vendors that use physicians located in just the U.S. are eligible for reimbursement and consequently have a aggressive edge in excess of RICU.

Additional, it says that it has by now started losing company mainly because of hospitals’ incapacity to get Medicare reimbursement.

THE Greater Trend

CMS has greatly expanded the listing of telehealth services it will reimburse for during the pandemic to include things like services these types of as emergency division visits, initial inpatient and nursing facility visits, and discharge working day administration.

While only fourteen states at this time have legitimate “payment parity” for telehealth, forty three states and the District of Columbia have implemented a telemedicine protection legislation, according to Foley & Lardner LLP report.

That report, between other people, claims telehealth will keep on to increase as an integral portion of healthcare as time goes on.

Final calendar year, Geisinger health system in Danville, Pennsylvania, implemented telehealth ICU technology in a number of of its hospitals to aid aid its in-individual medical team.

ON THE Report

“The Vital Care Ban is resulting in irreparable damage to RICU, which is suffering ongoing economic and reputational harms that simply cannot be remedied in the long term,” the court docket filing stated. “The equilibrium of the equities favors an injunction mainly because Defendants have by now admitted that there is a determined healthcare will need for the vital treatment that RICU would deliver but for the Vital Care Ban. And, eventually, preliminary injunction would be in the public interest mainly because, across the United States, Us residents stricken by the COVID-19 pandemic are in determined will need of vital treatment–a will need that RICU can aid meet up with. It is not hyperbole to say that the requested injunctive relief is in the public interest mainly because it could preserve lives.”

Twitter: @HackettMallory
E mail the writer: [email protected]