Furthering Access to Stroke Telemedicine Act

Did you ever wonder how all of the decisions about your health care are made on a National and State level? The government, through the Medicare and social security budget, determines some of the rules governing your health care coverage while some guidelines are determined by your individual health insurance policy. Currently, there is a bill in congress specifically directed towards expanding your access to emergency stroke care.

Emergency Stroke Care and Telemedicine

Stroke care has been one of the first areas of medicine to adopt the use of emergency telemedicine procedures. Because most rural hospitals do not have a specialized neurologist on site to determine patient eligibility for emergency TPA or intra arterial thrombolysis treatment, telemedicine consultations are often an integral part of emergency rural stroke care. When a patient with a stroke arrives at a rural hospital, there may not be a stroke specialist available who can determine whether or not it is safe to administer emergency blood thinners such as TPA. Using telemedicine, a doctor seeing the patient in the hospital and a doctor located at another hospital can work together to formulate a rapid and safe plan to properly treat the stroke.

Telemedicine has saved lives and has prevented serious disability in instances when patients would not have otherwise been able to receive the most up to date treatment.


In May 2015, a bill was introduced to the senate (S. 1465) and to the House of Representatives (H.R. 2799) to expand access to stroke Telemedicine care to Medicare patients in urban and suburban hospitals. Not all urban and suburban hospitals have on-site specialized neurological stroke specialists.

Often, emergency stroke patients need to be transferred from one hospital to another nearby hospital. Even if the destination hospital is only 20 or 30 minutes away, the brief time window required for safe emergency stroke treatment can elapse during transfer, allowing the stroke to worsen, causing death or permanent disability.

The bill is called the Furthering Access to Stroke Telemedicine Act or the FAST Act and it proposes to amend title XVlll of the Medicare Social Security Act to

  1. Expand access to stroke telehealth services to any site where eligible stroke patients are located and
  2. To waive the facility fee for this service.

This means that stroke patients who arrive at local urban or suburban hospitals that does not have a specialized stroke neurologist on site could still receive the most suitable and up to date treatments in whatever hospital they arrive to through telemedicine consultations and that Medicare would pay for the patient’s care. Additionally, patients would not have to pay for an additional facility fee for the service. The estimated expense of making this stroke telehealth care available and of Medicare covering the cost is $1 billion. The estimated long-term cost savings gained by prevention of stroke-related medical care, rehabilitation treatment and long-term nursing home care is approximately $2.2 billion.

When a bill passes in both the House of Representatives and the Senate, the president can then sign the bill to make it a law.

Politics and Your Health

Overall, while politics sometimes has a reputation of being arbitrary and baffling, in reality, there is a good deal of transparency and availability of information. The details of the regulations regarding your health care policies and your government provided coverage do change once in a while. However, information about the bills and proposals are often accessible online. When you have opinions that you want heard, you can send letters or contact your representatives to set up a personal meeting, either at their office locally within your state, or in their office in Washington DC.


Congressional Bill Website

US Government Publishing Office

TeleStroke units serving as a model of care in rural areas: 10-year experience of the TeleMedical project for integrative stroke care, Müller-Barna P, Hubert GJ, Boy S Bogdahn U, Wiedmann S, Heuschmann PU, Audebert HJ, Stroke, September 2014

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