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Telemedicine – The New Frontier in Medicare

On Friday, April 5, 2019, the Centers for Medicare and Medicaid Services (CMS) finalized a proposal to expand the Medicare Supplement Plan (MSP) and Medicare Health Insurance Program (MHIP) by creating a new category of benefits eligible for additional telemedicine coverage. The new benefit, which will be available in 2018 and fall 2018, will be expanded to create a total of $1.5 billion in additional benefits for the 2018-2019 fiscal year.

Medicare Supplement plans 2021 cover the list of Medicare telemedicine services mentioned above, but in recent years Congress and CMS have expanded the ability to offer Medicare FFS and Medicare Advantage telemedicine services. Telemedicine, which must be provided as primary care, is generally limited to Medicare Part B services provided by a physician or others. The physician must specify the number and type of telemedical service available to the patient in the form of a prescription or prescription medicine.

Under the MA’s plans, certain supplementary telemedical services will be offered as basic services rather than as supplementary services. Currently, MA planners have the opportunity to provide complementary telemedicine services, financed by additional premiums paid by students. Starting in 2020, CMS said, the rules will make it more likely that an MA plan will offer these benefits and that more freshmen will be able to take advantage of them.

“We tend to follow Medicare in the number of people with access to telemedical services and the quality of those services,” McSwain said.

In April, the Centers for Medicare and Medicaid Services passed a directive allowing Medicare Advantage to offer additional telemedicine services through 2020. CMS has pushed ahead with plans ahead of open enrollment this year, and the added flexibility of telemedicine has only made it more attractive to insurers and consumers. Insurers have done well with Medicare benefit plans in recent years, as their third-quarter profits most recently showed.

In a press release, CMS administrator Seema Verma called the move “an important step in bringing innovative technology to Medicare beneficiaries. I am heartened by the news, as 34 percent of Medicare recipients are enrolled in Medicare Advantage plans, a figure projected to rise 11.5 percent this year, according to CMS.

Today’s announcement builds on a report from the Department of Health’s Management and Budget Office released earlier this week that gave Medicare Advantage a $1.5 billion boost in its first year of expansion. Plan to provide additional services to chronically ill patients that are not necessarily health-related, but can take into account social determinants of health. Telemedicine can also improve the outcome of an organization and provide access to healthcare for elderly patients who do not have transport, such as people with disabilities

Med City News reported, the Centers for Medicare and Medicaid Services (CMS) will allow Medicare Advantage plans to cover a wider range of telehealth services. The new rule would give Medicare Advantage plans the flexibility to count certain telehealth specialists toward network adequacy requirements, including dermatology, psychiatry, cardiology, and primary care.

“CMS’s rapid changes to telehealth are a godsend to patients and providers and allows people to be treated in the safety of their home,” CMS Administrator Seema Verma said in a news release. “The changes we are making will help make telehealth more widely available in Medicare Advantage and are part of larger efforts to advance telehealth.”

With the new telemedicine benefits, Medicare Advantage plans will have the flexibility to offer beneficiaries a range of historic services. Medicare Advantage Plans, also known as Part C, typically offer the same coverage as original Medicare, but can compete for patients because of the quality of their medical care and the availability of health coverage.

The two types of coverage work well together, so it’s worth understanding how your plan is covered before you sign up. Medicare Advantage plans can offer beneficiaries access to a range of telemedicine services such as prescription drug coverage, home health care and other medical services. While Medicare now covers telemedicine services under original Medicare, they are not covered by Medicare’s Advantage plan, and they may have their own rules about who pays them and how to access them.

Approval of Medicare Advantage plans to cover additional telemedicine services as a basic service, rather than a supplemental service, means that Medicare plans pay for services provided through capitalized payments. This change gives the MA plan more flexibility in determining whether its telehealth offerings will reduce its overall costs. Coverage as a basic rather than a supplemental benefit will encourage Medicare benefit plans to expand TeleHealth coverage.

Today, the Centers for Medicare and Medicaid Services (CMS) released the final Medicare regulatory package, which includes rules that health insurers can use when they expand Medicare Advantage plans to include telemedicine services in 2020. The agency that manages Medicare Advantage programs has made a number of rule changes that could lead to more telemedicine coverage in Medicare preventive plans in the near future. CMS has introduced rules to encourage and expand Medicare’s use of TeleHealth services, and to allow insurers to include TeleHealth services in their 2020 Medicaid plans and other Medicare plans as primary care.

CMS has completed changes that would allow Medicare Advantage beneficiaries to access additional telemedicine services and new telemedicine services in Medicare prevention plans beginning in 2020.

These additional telemedicine services offer patients the opportunity to access healthcare instead of their home without having to go to a health care facility.

On Friday, the Centers for Medicare and Medicaid Services (CMS) announced that it has finalized the final version of its Medicare Telemedicine Plan D. Starting this year, seniors on Medicare Original will receive certain telemedicine benefits even if they live in rural areas. They will also start paying for virtual checks – allowing patients to connect with their doctors by phone or video chat across the country.