Policy Issues in Telemedicine The purpose of telemedicine is to remove distance as a barrier to healthcare. Although telemedicine is an accepted resource for bridging the gap between local and global healthcare, integrating telemedicine into existing healthcare infrastructures poses a challenge to both governments and policymakers (HRSA, 2011). Today, there are political barriers that prevent the expansion of telemedicine, including reimbursement issues raised by Medicare and private payers, state licensing, and liability and privacy concerns. Reimbursement Issues Reimbursement policies prevent the full integration of telemedicine into healthcare practice (Prinz, 2008). Today, there is no general reimbursement policy for telemedicine in the federal healthcare system (HRSA, 2011 and OAT, 2003). As a result, reimbursement for telehealth has been limited and somewhat haphazard. It is up to each state to specify which telehealth services, if any, are eligible for Medicaid reimbursement (HRSA, 2011 and OAT, 2003). There are two policies that support telehealth services. In 1997, the Balanced Budget Act (BBA) required the Health Care Financing Administration (HCFA) to pay for certain telehealth consultation services to Medicare beneficiaries. However, several administrative limitations have limited the effectiveness of this legislation. For example, patients had to be located in rural health professional shortage areas (HPSAs). This meant that many patients had access to general practitioners but not specialists, and store-and-forward consultations were excluded. In 2000, the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act (SB 2505) attempted to correct some of these limitations. For example, reimburse a person for telehealth… half the paper… (2003). Telehealth Reimbursement Report – HRSA. Retrieved March 30, 2011, from http://www.hrsa.gov/ruralhealth/about/telehealth/reimburse.pdf Prinz, L., Cramer, M. & Englund, A. (2008). Telemedicine: A policy analysis for quality, impact on patient outcomes, and policy feasibility. Nurse Outlook, 56(1), 152-158doi:10.1016/j.outlook.2008.02.005Telehealth connections for children and youth (2005). Telemedicine for CSHCN: A State-by-State Comparison of Drug Reimbursement Policies and Title V Activities. Retrieved March 30, 2011, from http://www.ichp.ufl.edu/documents/Telemedicine%20in%20Medicaid%20and% 20Title%20V%20Report.pdfWhitten, P. (2002). Telemedicine in Michigan: A policy report addressing legal and regulatory barriers. Retrieved March 30, 2011, from http://www.ippsr.msu.edu/publications/artelemedicine.pdf