{"id":27447,"date":"2020-05-22T17:48:00","date_gmt":"2020-05-22T17:48:00","guid":{"rendered":"https:\/\/dev.mtelehealth.com\/?p=27447"},"modified":"2020-05-22T17:48:00","modified_gmt":"2020-05-22T17:48:00","slug":"cms-finalizes-telehealth-reimbursement-for-ma-plans-esrd-patients","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/cms-finalizes-telehealth-reimbursement-for-ma-plans-esrd-patients\/","title":{"rendered":"CMS Finalizes Telehealth Reimbursement for MA Plans, ESRD Patients"},"content":{"rendered":"\n

The Centers for Medicare & Medicaid Services has issued a final rule on expanded telehealth coverage for members in Medicare Advantage plans and those living with end-stage renal disease.<\/h2>\n\n\n\n

By\u00a0Eric Wicklund<\/a><\/p>\n\n\n\n

May 22, 2020 – The Centers for Medicare & Medicaid Services is finalizing plans to expand telehealth coverage in Medicaid Advantage plans.<\/p>\n\n\n\n

Building on a proposed rule issued this past February<\/a>, CMS is encouraging MA plans to increase access to telehealth services for members living in rural areas and including specialties, such as dermatology, psychiatry, cardiology, otolaryngology, ophthalmology, allergy and immunology, nephrology, primary care, gynecology and OB\/GYN, endocrinology and infectious diseases, in meeting CMS network adequacy standards.<\/p>\n\n\n\n

\u201cCMS\u2019 rapid changes to telehealth are a godsend to patients and providers and (allow) people to be treated in the safety of their home,\u201d CMS Administrator Seema Verma said in a press release<\/a>. \u201cThe changes we are making will help make telehealth more widely available in Medicare Advantage and are part of larger efforts to advance telehealth.\u201d<\/p>\n\n\n\n

The final rule also expands the opportunities for patients with end-stage renal disease (ESRD) to get coverage for telehealth services.<\/p>\n\n\n\n

Following through on provisions in the 21st<\/sup> Century Cures Act and an executive order issued by President Trump in July 2019, CMS will now allow beneficiaries with ECRD to enroll in the MA plan that best first their needs, beginning in 2021.<\/p>\n\n\n\n

This opens the door to, among other things, home-based dialysis programs that use remote patient monitoring technology for care management and transplant programs that use telehealth to improve organ procurement and post-operative recovery.<\/p>\n\n\n\n

Roughly 30 million Americans, or 15 percent of the adult population, are affected by chronic kidney disease. Of that number, more than 660,000 have kidney failure, and almost 470,000 are on dialysis. More than 193,000, meanwhile, have a functioning kidney transplant, which requires them to follow a very strict daily medication regimen.<\/p>\n\n\n\n

According to the National Kidney Foundation, telemedicine offers a promising alternative<\/a><\/strong> to in-person care, most often delivered in a doctor\u2019s office or dialysis clinic. Clinicians can remotely monitor a patient\u2019s blood pressure and other vital signs, as well as offering resources for medication adherence and diet plans.<\/p>\n\n\n\n

The agency said it is issuing a subset of its proposed changes now to enable MA plans to add those services to their 2021 plans. Further changes will be announced later.<\/p>\n\n\n\n

Among those praising the CMS rule was the Better Medicare Alliance.<\/p>\n\n\n\n

\u201cThis final rule takes important strides to preserve and strengthen the Medicare Advantage coverage that 24.4 million beneficiaries rely on today,\u201d said Allyson Y. Schwartz, the group\u2019s president and CEO. \u201cThe added flexibility to address the needs of all beneficiaries, with particular attention to those with complex chronic conditions, provides the opportunity for Medicare Advantage to offer greater access to care, new innovations in care delivery, and lower costs for millions of Americans.\u201d

\u201cAll told, this rule contains reforms that can unleash Medicare Advantage\u2019s potential to offer innovative care for the chronically ill, including newly enrolled beneficiaries with end-stage renal disease,\u201d she added. \u201cBetter Medicare Alliance looks forward to continuing to work with CMS to address issues related to the coronavirus, as well as parts of the rule that will be attended to later, with the goal of ensuring that Medicare Advantage continues to modernize Medicare to meet beneficiaries\u2019 needs and offer high-quality care at a lower cost.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

The Centers for Medicare & Medicaid Services has issued a final rule on expanded telehealth 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