{"id":27559,"date":"2020-06-04T15:10:29","date_gmt":"2020-06-04T15:10:29","guid":{"rendered":"https:\/\/dev.mtelehealth.com\/?p=27559"},"modified":"2020-06-04T15:10:29","modified_gmt":"2020-06-04T15:10:29","slug":"home-health-industry-getting-closer-to-reimbursement-for-telehealth-visits","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/home-health-industry-getting-closer-to-reimbursement-for-telehealth-visits\/","title":{"rendered":"Home Health Industry \u2018Getting Closer\u2019 to Reimbursement for Telehealth Visits"},"content":{"rendered":"\n<p>By&nbsp;<a href=\"https:\/\/homehealthcarenews.com\/author\/rholly\/\">Robert Holly<\/a>&nbsp;|&nbsp;May 18, 2020<\/p>\n\n\n\n<p>Despite significant roadblocks, the home health industry is getting closer to securing direct reimbursement for visits delivered via telehealth technology, industry insiders believe.<\/p>\n\n\n\n<p>Over the past two few months, the Centers for Medicare &amp; Medicaid Services (CMS) and the White House&nbsp;<a href=\"https:\/\/www.kff.org\/womens-health-policy\/issue-brief\/opportunities-and-barriers-for-telemedicine-in-the-u-s-during-the-covid-19-emergency-and-beyond\/\">have taken numerous steps<\/a>&nbsp;to ramp up the use of telehealth services during the COVID-19 emergency. In doing so, federal policymakers hoped to minimize person-to-person contact and preserve stockpiles of personal protective equipment (PPE).<\/p>\n\n\n\n<p>\u201cWe dramatically expanded access to telehealth \u2026 for Medicare beneficiaries,\u201d President Donald Trump said&nbsp;<a href=\"https:\/\/homehealthcarenews.com\/2020\/04\/latest-round-of-covid-19-medicare-waivers-changes-little-for-struggling-home-health-agencies\/\">during a late April White House coronavirus task-force briefing<\/a>. \u201cThe number of Medicare patients using telehealth has increased from roughly 11,000 a week to more than 650,000 [people] a week.\u201d<\/p>\n\n\n\n<p>But while certain health care practitioners and providers have been granted newfound telehealth flexibility under Medicare, home health agencies have largely been left to fend for themselves.<\/p>\n\n\n\n<p>Currently, there isn\u2019t a way for home health providers to bill for in-home telehealth visits \u2014 or count remote visits toward low-utilization payment adjustment (LUPA) thresholds.<\/p>\n\n\n\n<p>In other words: The coronavirus might have led to a quantum leap for telehealth broadly, but not for the nation\u2019s in-home care providers, many of which have transitioned to the front lines of the outbreak.<\/p>\n\n\n\n<p>As a result of the coronavirus, the demand for telehealth technology is projected to increase seven-fold by 2025,&nbsp;<a href=\"https:\/\/go.frost.com\/NA_PR_TH_MFernandez_K488_Telehealth_May20\">according to research<\/a>&nbsp;from business consulting firm Frost &amp; Sullivan research.<\/p>\n\n\n\n<p>\u201cThis is an opportunity we don\u2019t want to miss,\u201d National Association for Home Care &amp; Hospice (NAHC) President William A. Dombi said during&nbsp;<a href=\"https:\/\/register.gotowebinar.com\/register\/1882099331159704333\">a May 15 virtual town hall<\/a>&nbsp;hosted by Home Health Care News.<\/p>\n\n\n\n<p>Home health providers originally weren\u2019t supposed to be left out of the sudden telehealth boom.<\/p>\n\n\n\n<p>The Coronavirus Aid, Relief and Economic Security (CARES) Act was passed by Congress with overwhelming, bipartisan support and signed into law by President Trump on March 27. Leading up to that date, many felt confident that legislation would create a pathway for direct home health telehealth reimbursement.<\/p>\n\n\n\n<p>On its end, NAHC\u2019s policy team participated in multiple early-morning discussions in an effort to secure reimbursement for telehealth services under the home health benefit while also making sure telehealth could be provided under the hospice program.<\/p>\n\n\n\n<p>\u201cWe thought everything was safe,\u201d Dombi said. \u201cWe were still where we needed to be in the game to get reimbursement under the home health benefit and authorization under the hospice program.\u201d<\/p>\n\n\n\n<p>Right before the CARES Act was signed into law, however, its legislative language shifted. Instead of directly creating that reimbursement pathway, it merely instructed CMS to \u201cencourage\u201d the use of telehealth.<\/p>\n\n\n\n<p>Yet CMS says it cannot unilaterally create a mechanism for home health telehealth reimbursement without congressional action.<\/p>\n\n\n\n<p>NAHC leaders and other industry advocates are now hoping for another shot on Capitol Hill.<\/p>\n\n\n\n<p>\u201cWe\u2019re back at it,\u201d Dombi said. \u201cAnd we\u2019re hoping to see [this] week, early, legislation introduced that would allow for payment of telehealth to home health agencies in one of two ways, if not both ways.\u201d<\/p>\n\n\n\n<p>The first of those two ways is through the home health benefit itself, he clarified. The second option is to put home health agencies and hospices in the same position as physicians, therapists and nurse practitioners (NPs) by allowing them to separately bill Medicare Part B for telehealth services furnished.<\/p>\n\n\n\n<p>\u201cI think we\u2019re getting closer to making it happen,\u201d Dombi said.<\/p>\n\n\n\n<p>Moorestown, New Jersey-based Bayada Home Health Care is among the providers pushing for more telehealth flexibility, according to David Totaro, its chief government affairs officer. Totaro also participated in the May 15 virtual town hall, in addition to Stephen Vacarro, president of provider solutions for HHAeXchange, a home care technology partner.<\/p>\n\n\n\n<p>At the very least, Bayada officials believe telehealth visits should count toward LUPAs, Totaro, who also serves as chairman for the Partnership for Medicaid Home-Based Care (PMHC), said.<\/p>\n\n\n\n<p>While Dombi was optimistic about home health telehealth support coming soon, Totaro was more measured.<\/p>\n\n\n\n<p>\u201cGiven today\u2019s environment, it\u2019s probably not at all certain whether this is going to be feasible,\u201d he said during the town hall.<\/p>\n\n\n\n<p>Traditional, fee-for-service Medicare hasn\u2019t presented an opportunity for home health telehealth reimbursement, but providers can still find some payment opportunity under Medicare Advantage (MA) and Medicaid.<\/p>\n\n\n\n<p>\u201cDon\u2019t ignore that many of the Medicare Advantage plans are now recognizing and paying for telehealth services as well as state Medicaid programs,\u201d Dombi said. \u201cIf your state Medicaid program isn\u2019t paying for it, roll up your sleeves and do some lobbying.\u201d<\/p>\n\n\n\n<p>HHAeXchange clients have conducted roughly 5,000 remote nursing assessments in the Medicaid space, Vacarro said.<\/p>\n\n\n\n<p>If the reimbursement circumstances are right, Medicaid-reimbursed in-home care providers may be quick to turn to telehealth and other technology tools in order to help cut costs on expensive PPE, he noted.<\/p>\n\n\n\n<p>\u201cThey just don\u2019t have the financial ability to go out and purchase PPE,\u201d Vacarro said. \u201cThey need other tools they can leverage to protect their caregivers during this critical time.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By&nbsp;Robert Holly&nbsp;|&nbsp;May 18, 2020 Despite significant roadblocks, the home health industry is getting closer to 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