Ashley Buehnerkemper
We previously discussed how Medicare telehealth benefits for the patient health emergency (PME) had been extended for 90 days, but it was still unclear if/when Medicare telehealth benefits would return to normal (link to that previous blog) or if certain aspect would stick around even after the PME ended.
Well, we recently got a little more clarity on the subject. A short time ago, the Centers for Medicare & Medicaid Services (CMS) proposed changes to expand telehealth permanently. This coincided with the recent Executive Order on Improving Rural and Telehealth Access from the Trump administration.
So it appears there is a strong push growing to make at least some of the current Medicare telehealth benefits permanent. According to the CMS, both these proposals aim to improve access and convenience of care for Medicare patients, specifically those in rural areas. This has been an ongoing goal of the CMS for a few years. In 2019, Medicare started paying for virtual check-ins using phone or video chat, where patients would see if they should come in for an in-person visit. Then of course, when COVID-19 hit, CMS quickly expanded telehealth services payments along with other changes, to help Medicare patients reach their doctors while staying safe. Prior to the PHE, 14,000 patients received telehealth care per week. But during the PME (mid-March and still going), the number of patients receiving telehealth care a week is now over 10 million. With such a dramatic increase, it’s understandable why the CMS believes it’s important to keep some or all of the current telehealth benefits for Medicare patients.1
In the CMS release, Seema Verma, CMS administrator, weighed in on the benefits of telehealth access. She said, “Telemedicine can never fully replace in-person care, but it can complement and enhance in-person care by furnishing one more powerful clinical tool to increase access and choices.” She also mentioned that the proposed expansion of telehealth represents a revolution in healthcare delivery – one that the healthcare system has already been adapting too quickly and effectively.1
CMS is also seeking public input on what other services to permanently add to the telehealth list beyond the PHE, in order to give doctors and patients time as they continue transitioning into in-person care again. This will also give communities time to consider whether these services should be delivered permanently through telehealth outside of the PHE. According to the CMS, these public comments on the proposed rules are due by October 5, 2020.1
And how do private insurers feel about this? Some of the largest insurance companies, such as UnitedHealthcare and Anthem, have previously said they haven’t decided beyond September or October if they’ll extend the new policies they’ve adopted. BlueCross BlueShield of Tennessee previously said it’s the first major insurer to make telehealth coverage of services permanent, but still hasn’t determined how much it will eventually pay for the care. Some other insurers, like Cigna and BlueCross BlueShield in North Carolina, said they’ll continue covering telehealth services at pandemic levels through the end of the year.2
But with the recent Executive Order and CMS proposal, do these insurance companies and others still feel the same way?
It’s hard to say what the final decisions will be with all of this, but even though nothing has been set in stone yet, there’s clearly a good amount of interest and effort to keep some or all of the new Medicare telehealth benefits in place.
And with those efforts, we may be getting an answer sooner rather than later. If these services do affect your care, it’s a good idea to keep up to date on what’s happening and still prepare for what changes might be needed for your telehealth services.
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Sources:
2 Is Telemedicine Hear to Stay? (2020, August 3).