Census triggers loss of telehealth services

Hundreds of thousands of Medicare beneficiaries in almost 100 counties across the United States and its territories will be losing coverage for telehealth services because they no longer live in federally designated rural areas.

As a result of the 2010 Census, 97 counties in 36 states and territories are being redefined as metropolitan -- rather than rural -- Standard Metropolitan Statistical Areas (SMSAs), according to officials with the American Telemedicine Association (ATA). That change in status revokes the option for Medicare recipients in those counties to use video conferencing services for healthcare.

ATA officials said Medicare doesn't cover telemedicine in metropolitan areas, where more than 80 percent of all Medicare recipients live.

The news isn't entirely bad, though. The new SMSA rules also change 28 counties from metropolitan to non-metropolitan, thus making Medicare residents in those counties eligible for telehealth services.

The changes were discussed during the ATA's monthly "This Month in Telemedicine" videocast during the week of March 25, then outlined in a press release issued on March 27.

”When it comes to telemedicine, Congress has long overlooked the need for telemedicine services to residents of urban counties, despite the fact that they often suffer similar problems accessing healthcare. Now, because of a statistical quirk, even more people will lose coverage of these services, reducing access and care,” said Jonathan Linkous, the ATA's CEO, in the press release. “Medicare should cover remote health services for all beneficiaries, regardless of location. We call on Congress to ensure that existing beneficiaries will not lose coverage for these services.”

During the videocast, Linkous and Gary Capistrant, ATA's senior director of public policy, said the association will petition federal officials to enable Medicare recipients in the newly changed counties to continue to qualify for telehealth services.

'We're going to need a lot of support," said Linkous, who added that that ATA believes those counties should be grandfathered.

Among the hardest hit states, Linkous and Capistrant said, is Delaware, whose three counties – New Castle, Kent and Sussex – are now all classified as urban counties. Other states heavily affected by the SMSA changes are Virginia, North Carolina and Texas.

According to the ATA, the following counties are slated to lose telehealth coverage for Medicare beneficiaries:

  • Alabama – Pickens County
  • Arizona – Cochise County
  • Arkansas – Little River County
  • Connecticut – Windham County
  • Delaware – Sussex County
  • Florida – Citrus, Gulf, Highlands, Sumter and Walton counties
  • Georgia – Lincoln, Morgan, Peach and Pulaski counties
  • Hawaii – Kalawao and Maui counties
  • Idaho – Butte County
  • Illinois – De Witt, Jackson and Williamson counties
  • Indiana – Scott County
  • Iowa: – Plymouth County
  • Kansas – Kingman County
  • Kentucky – Allen and Butler counties
  • Louisiana – Iberia, St. James, Tangipahoa, Vermilion and Webster parishes
  • Maryland – St. Mary's and Worcester counties
  • Michigan – Midland and Montcalm counties
  • Minnesota – Fillmore, Le Sueur, Mille Lacs and Sibley counties
  • Mississippi – Benton and Yazoo counties
  • Montana – Golden Valley County
  • Nebraska – Hall, Hamilton, Howard and Merrick counties
  • New York – Jefferson and Yates counties
  • North Carolina – Craven, Davidson, Gates, Iredell, Jones, Lincoln, Pamlico and Rowan counties
  • North Dakota – Oliver and Sioux counties
  • Oregon – Josephine and Linn counties
  • Pennsylvania – Adams, Columbia, Franklin, Monroe and Montour counties
  • Puerto Rico –Utuado Municipio
  • South Carolina – Beaufort, Chester, Jasper, Lancaster and Union counties
  • South Dakota – Custer County
  • Tennessee – Campbell, Crockett, Maury, Morgan and Roane counties
  • Texas – Falls, Hood, Hudspeth, Lynn, Martin, Newton and Oldham counties
  • Utah – Box Elder County
  • Virginia – Augusta, Buckingham, Culpeper and Floyd counties and Staunton City and Waynesboro City
  • Washington – Columbia, Pend Oreille, Stevens and Walla Walla counties
  • West Virginia – Fayette and Raleigh counties
  • Wisconsin – Green County


According to the ATA, the following counties are slated to gain telehealth coverage for Medicare beneficiaries:

  • Idaho – Power County
  • Indiana – Franklin, Gibson and Greene counties
  • Kansas – Franklin County
  • Kentucky – Nelson County
  • Massachusetts – Franklin County
  • Michigan – Ionia County
  • Mississippi – George and Stone counties
  • Missouri – Howard and Washington counties
  • North Carolina – Anson and Greene counties
  • Ohio – Erie County
  • Tennessee – Stewart County
  • Texas – Calhoun, Delta and McLennan counties
  • Utah – Summit County
  • Virginia – Cumberland, King and Queen, Louisa and Pittsylvania counties and Danville City
  • West Virginia – Morgan and Pleasants counties