In 2015, lawmakers at both the federal and state levels recognized—and took action to alleviate—the lack of readily available and affordable healthcare options: namely, through legislation that opened the door for telehealth expansion. In fact, this Medscape article reveals that in the last year alone, “200 bills addressing telehealth were introduced in 42 states.” That’s a lot of legislative legwork. And while we can’t shrink and teleport healthcare providers through a television—Willy Wonka-style—quite yet, the growing demand for healthcare efficiency and convenience continues to propel telehealth legislation forward. Although many of these laws have yet to take effect, they’re already causing some serious buzz in the healthcare industry. Here’s the latest update:

The State of Rehab Therapy in 2018 - Regular BannerThe State of Rehab Therapy in 2018 - Small Banner

1. Comprehensive Care for Joint Replacement (CJR) Initiative

Back in November 2015, we learned that CMS’s long-anticipated Comprehensive Care for Joint Replacement (CJR) initiative would officially take effect on April 1, 2016. So, through a bundled payment program for knee and hip replacements, 790 hospitals soon will be held accountable for the quality and cost of their care delivery throughout these specific episodes—including post-surgery rehab. The total timeframe can extend up to 90 days after discharge, but the program doesn’t stop there. This mHealthIntelligence article explains the far-reaching impact of CJR: “the rule waives geographic and originating site requirements that factor into reimbursement, enabling the hospital to use telehealth to facilitate the patient’s transfer to a skilled nursing facility and/or home.”

These relaxed rules give providers more freedom to use telehealth technology and to develop their own programs for delivering better care at a lower cost. The same article goes on to explain that this transition is important because it also could be “the first step in establishing telehealth as the standard of care for all post-discharge programs, not just those focused on knee and hip replacements.”

2. The Telemedicine Parity Act of 2015

If passed, this bill would authorize “additional telehealth providers, including a certified diabetes educator or licensed respiratory therapist, audiologist, occupational therapist, physical therapist, or speech language pathologist.” Furthermore, the Telemedicine Parity Act of 2015 expands the term “originating site” for payment purposes. This would allow Medicare to pay for telehealth services regardless of whether the patient lives in an urban or rural setting.

3. TELE-MED Act of 2015

This piece of legislation aims to allow specific licensed Medicare providers to provide telemedicine services to certain Medicare patients who reside in different states, even if the provider is not licensed in the particular state in which the patient resides. The bill defines participating physician or practitioner as:

  • A physician (as defined in section 1861(r)) who is a participating physician or supplier (as defined in section 1842(h)(1)).
  • A practitioner (as defined in section 1842(b)(18)(C)) who is a participating physician or supplier (as defined in section 1842(h)(1)).

Even though rehab therapists might not “fit the bill” just yet, many states are forming compacts to address licensure issues that could impede the expansion of telehealth.  

4. Food and Drug Administration (FDA) Vera Approval

One technological advancement that recently hit the headlines in the telehealth realm was the FDA’s approval of Reflexion Health’s application, Vera. This VentureBeat article explains the power of this FDA-approved technology: “patients will see an avatar on their television screen that will coach and motivate them to perform the exercises at home. The sensor will track their progress and report the data back to the patient’s physical therapist who is also monitoring their activity in real-time.” This kind of technology expands telehealth possibilities even further, as it allows therapists to get a glimpse into their patients’ progress at home.

5. Ambiguity Concerns

As new technology surfaces—and new legislation takes effect—some states remain concerned about telehealth licensure, safety, and security. That’s why many have chosen to enact their own stipulations and regulations surrounding telehealth. For example, this Health Law & Policy article explains that “most [states] require something more than an online questionnaire.” In fact, some states even require a face-to-face initial evaluation before any telehealth treatment can be administered. As we move forward, individual states inevitably will have to decide how to handle any ambiguity in the newly expanded laws—including gray areas surrounding coverage and reimbursement.


Whether or not providers are ready, telehealth expansion and adoption shows no signs of slowing down in 2016. Are you on board? Tell us what you think about the transition in the comments section below.

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