mr. cavanaugh? yes, go ahead. >> thank you, mr. chairman, and thank you for helping me ask my question, and i appreciate the answer. this is a home health care question. some of our hospitals more -- fewer than used to provide home health care services because they can't afford to. but the affordable care act includes a provision that requires medicare beneficiaries to have a face-to-face encounter with a physician who certifies the need for that home health care services. the implementation of this face-to-face requirement raises lots of concerns with home health care provider, hospital-based or otherwise. and the documentation that is necessary, it sure seems to the providers as unclear. and the backlog of audits is increasing. there is a real uncertainty as to what the cms standard is for providing satisfactory face-to-face encounter. most of the appeals have been overturned in favor of the home health care provider. but my question is do you see this as a problem? does cms have a plan to respond to clear up the confusion provid

mr. cavanaugh? yes, go ahead. >> thank you, mr. chairman, and thank you for helping me ask my question, and i appreciate the answer. this is a home health care question. some of our hospitals, more -- fewer than used to provide home health care services because they can't afford to. but the affordable care act includes a provision that requires medicare beneficiaries to have a face-to-face encounter with a physician who certifies the need for that home health care services. the implementation of this face-to-face requirement raises lots of concerns with home health care provider, hospital-based or otherwise. and the documentation that is necessary, it sure seems to the providers as unclear. and the backlog of audits is increasing. there is a real uncertainty as to what the cms standard is for providing satisfactory face-to-face encounter. most of the appeals have been overturned in favor of the home health care provider. but my question is do you see this as a problem? does cms have a plan to respond to clear up the confusion, prov

mr. cavanaugh taking over.f will perhaps will then be in a position to clearly solidify its own plans. not to say there's anything near term, but one would expect that to continue. >> also got an update on tempur sealy. at the mattress maker, the company announced mark searbury would step down and will be replaced by an interim ceo, timothy yagi. so i guess, it's a win for them. >> a win for an activist. i've seen the press releases from my inbox. >> that's what they got, a management shake-up. >>> coming up next the inside story of how alibaba went from a company that hardly anyone knew about, the author of the new book, who is a former executive will be joining us live at post 9 with the inside story. "squawk on the street" will return in a minute. if you're running a business legalzoom has your back. over the last 10 years we've helped one million business owners get started. visit legalzoom today for the legal help you need to start and run your business. legalzoom. legal help is here. bring us your aching

mr. cavanaugh answered some questions about the metropolitan statistical area restrictions that we have. that's a very antiquated assumption that if you increase telemedicine, you're going increase costs. in fact, you're going to take that very scarce workforce that we have in rural america and you're going to be able to extend it. it will be more efficient. and you'll create access in our communities. >> okay. very good. thank you very much for being here and your testimony. i appreciate it. thanks, mr. chairman. >> thank you. senator cochran? >> mr. chairman, dr. henderson, you mentioned in your testimony that the reimbursement parity issue was an important factor in the growth of services that are rendered through television and telehealth services. the diabetes pilot project you described a real are really remarkable. and obviously i like the potential for significant cost savings if they could be expanded into communities across the country. what do you see as the programs that could be expanded? are we talking about the diabetes pilot project? is that a possibility to serve more co

mr. cavanaugh, i understand the centers for medicaid and medicare services restrict reimbursement for telehealth based on geographic locations. how do you administer that? how do you choose which urban areas, for example, are more eligible than others for telehealth reimbursement? >> thank you for the question, senator. in this statute, it gives us instruction to allow telehealth to be provided in certain geographic areas. pleased that with help from our colleagues at the office of rural health policy a few years ago, we changed our regs to expand the definition of rural areas that qualify. but the geographic restrictions really originate in the statute. the good news is through the innovation center, which congress created, we're able to move beyond those barriers and test new models of telehealth without regard to the geographic barriers and some of the other statutory restrictions. we have a number of very interesting telehealth models that are being tested currently, including the health link model i mentioned in my testimony. >> thank you very much. >> senator moran? >> mr. chairman, thank

mr. cavanaugh, i understand the centers for medicaid and medicare services restrict reimbursement for telehealth based on geographic locations. how do you administer that? how do you choose which urban areas, for example, are more eligible than others for telehealth reimbursement? >> thank you for the question senator. in this statute, it gives us instruction to allow telehealth to be provided in certain geographic areas. pleased that with help from our colleagues at the office of rural health policy a few years ago, we changed our regs to expand the definition of rural areas that qualify. but the geographic restrictions really originate in the statute. the good news is through the innovation center which congress created we're

mr. chairman again thank you for holding this was at fort hood. this is a topic that means a lot to the people in my state. >> we have to win is on the first panel sean cavanaugh deputy administrator of the center for medicare centers for medicare and medicaid services, and tom morris, associate administrator for the federal office of rural health policy, health resources and services administration. we are pleased you're both here and we will listen to your opening statements. >> mr. chairman, and members of the committee i want to thank you for the opportunity to testify today on behalf of the old resources and services administration into federal office of robot on the topic of rural health. i'm pleased to discuss that only the challenges that you outline but also some of the accomplishments of our programs. across the department of health and human services is a range of programs and resources that support rural communities. in 2014 this include $11 billion in grant funding that went to rural communities. my office serves as the focal point with a continued focus on improving access to care. they are nearly 50 the many people living in rural areas about 15