Medicare and telehealth

FEDERAL HEALTH POLICY UPDATE FOR THE WEEK OF SEPTEMBER 12-16

The following is the latest health policy news from the federal government for the week of September 12-16.  Some of the language used below is taken directly from government documents. No Surprises Act The Department of Health and Human Services, the federal Office of Personnel Management, the Internal Revenue Service, the Department of the Treasury, the Department of Labor, and the Employee Benefits Security Administration have issued a request for information (RFI) seeking stakeholder comment on how to implement the No Surprises Act’s requirement that health care providers and payers give explanations of benefits and good-faith estimates of costs for [...]

MedPAC Discusses Post-COVID Telehealth

Should Medicare continue to encourage the use of telehealth when the COVID-19 pandemic ends? Should it continue to pay for telehealth when the there is no “tele” in the service and it is audio only? And should Medicare pay different rates for visits in person, telehealth visits, and audio-only (that is, telephone) visits? These were among the questions addressed by members of the Medicare Payment Advisory Commission during their public meetings last week. Members also discussed the need for further analysis of the effectiveness of telehealth and audio-only visits, how to identify audio-only visits on Medicare claims, how to collect [...]

2021-11-17T06:00:10-05:00November 17, 2021|Medicare, Medicare reimbursement policy, MedPAC, Telehealth|

Is Telehealth Too Expensive To Keep?

That’s the question Congress is asking these days. While health care interests and consumers are almost unanimous in their enthusiasm for telehealth, Congress is questioning whether telehealth is too expensive to preserve after the threat of COVID-19 passes. Prior to the pandemic, Medicare mostly limited the use of telehealth to rural areas where access to providers is limited.  Once the public health emergency became serious Medicare waived many of its limits on the use of telehealth so that elderly patients could stay in touch with their doctors.  On the whole, patients have viewed telehealth favorably and providers are very enthusiastic [...]

2021-05-25T06:00:16-04:00May 25, 2021|Medicare reimbursement policy, Telehealth|

MedPAC Talks Telehealth

Expanded telehealth is here to stay, members of the Medicare Payment Advisory Commission agreed at their September public meeting. What they do not yet know is in what form. Among the issues that need to be addressed in any post-COVID-19 expansion of Medicare-covered telehealth services are: Whether affording access to telehealth services would exacerbate the digital divide and leave some Medicare beneficiaries with less access to care than others. Whether audio-only coverage, temporarily permitted during the pandemic, should be continued. Whether greater use of telehealth might foster greater use of low-value services. Whether use of non-HIPAA-compliant video technology should continue [...]

CMS to Congress: You’re the Impediment to Greater Use of Telehealth

The primary obstacle to Medicare making greater use of telehealth is current laws, the Centers for Medicare & Medicaid Services has told Congress in a new report. The report, mandated by the 21st Century Cures Act, outlines the extent of telehealth utilization today, describes its benefits, and suggests potential new and expanded uses for telehelath, but it also notes that Current restrictions on eligible telehealth originating sites appear to be the greatest barrier to preventing the expansion of Medicare telehealth services.  The two most significant Medicare restrictions are:  1) requiring the originating site to be located in certain types of [...]

2018-11-20T06:00:23-05:00November 20, 2018|Medicare, Telehealth|

Physicians Push Back Against Medicare Telemedicine Proposal

A proposal to enable Medicare to make greater use of telemedicine as a means of serving patients is receiving surprising pushback from physicians. The Centers for Medicare & Medicaid Services has proposed paying doctors $14 for what would amount to a five-minute telephone “check-in” call with patients. Some physicians note that they already have such telephone conversations patients – and do not charge for those calls.  Others fear the new service will increase their patients’ health care costs because they would incur a co-pay for such conversations.  The chairman of the Medicare Payment Advisory Commission (MedPAC), himself a physician, has [...]

MedPAC Meets

Last week the Medicare Payment Advisory Commission held two days of public meetings in Washington, D.C. During the sessions MedPAC, a non-partisan legislative branch agency that advises Congress on Medicare payment issues, addressed the following subjects: a Medicare Advantage status report a Medicare prescription drug program (Part D) status report hospital inpatient and outpatient payments physician payments ambulatory surgical center, dialysis center, and hospice payments post-acute care facility payments the hospital readmissions reduction program telehealth accountable care organizations Go here to see the issue briefs and presentations used during the meetings.

Telehealth on the Upswing

A number of recent developments suggest that serving patients with the assistance of telehealth services will become more commonplace in the near future. The Medicare MACRA and MIPS payment programs will include new billing codes for telehealth services, according to regulations published earlier this month. Also earlier this month, the House passed legislation, The Vets Act (H.R. 2123), that would authorize the Veterans Administration to make greater use of telehealth. And when the U.S. Department of Health and Human Services’ Office of the Inspector General recently announced plans to audit Medicaid programs for telehealth payments, it cited among its reasons [...]

2017-11-28T06:00:17-05:00November 28, 2017|Medicaid, Medicare, Medicare regulations|

MedPAC Meets

Members of the Medicare Payment Advisory Commission met last week in Washington, D.C. Among the issues they discussed during their two days of meetings were Medicare coverage policy, Medicare coverage of telehealth services, pharmacy benefit managers and specialty pharmacies, and physician supervision requirements in critical access and small rural hospitals. Go here to see the issue briefs and presentations that were discussed during the meeting.

2017-09-13T06:00:10-04:00September 13, 2017|Medicare, MedPAC|
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