{"id":5408,"date":"2018-06-28T05:23:52","date_gmt":"2018-06-28T05:23:52","guid":{"rendered":"http:\/\/tele.healthcare\/?p=5408"},"modified":"2018-06-28T05:23:52","modified_gmt":"2018-06-28T05:23:52","slug":"medicare-advantage-organizations-provided-new-opportunities-to-offer-telehealth-benefits","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/medicare-advantage-organizations-provided-new-opportunities-to-offer-telehealth-benefits\/","title":{"rendered":"Medicare Advantage Organizations Provided New Opportunities to Offer Telehealth Benefits"},"content":{"rendered":"<p class=\"rtejustify\">Earlier this year, President Trump signed into law the Bipartisan Budget Act of 2018 (BBA), which incorporates provisions from the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 and improves access to telehealth services in Medicare Advantage. Pub. L. No. 115-123. Among other provisions impacting Medicare Advantage Organizations (MAOs), the BBA authorizes MAOs to offer additional telehealth benefits as basic benefits beyond original Medicare (Part A and Part B) limitations. <i>Id. <\/i>at Div. E., Title III, Subtitle C, \u00a7 50323.<\/p>\n<h3 class=\"rtejustify\"><strong>Background<\/strong><\/h3>\n<p class=\"rtejustify\">Despite the significant promise telehealth technology holds for improving access to care, very few Medicare beneficiaries actually receive any services through telehealth technology. The Medicare Payment Advisory Commission (MedPAC) reported earlier this year that less than 1% of Medicare beneficiaries made use of any telehealth services between 2014 and 2016.<\/p>\n<p class=\"rtejustify\">Prior to the enactment of the BBA, MAOs could offer only limited telehealth benefits as basic benefits under Section 1834(m) of the Social Security Act (SSA). Telehealth services would be reimbursed only if they were provided by a physician or practitioner through telecommunications to an enrollee located \u201cat an originating site\u201d (e.g. a physician\u2019s office, clinic) \u201cin an area . . . designated as a rural health professional shortage area . . . ; in a county that is not included in a Metropolitan Statistical Area; or from an entity that participates in a Federal telemedicine demonstration project [that had been previously approved by the Secretary].\u201d SSA \u00a7 1834(m). Furthermore, for MAOs to receive payment for telehealth services, an interactive video and audio telecommunications system had to be used. Other telehealth benefits could be provided only as supplemental benefits. (Supplemental benefits are either covered by an additional premium payment from the enrollee, or are funded through \u201crebates\u201d reflecting the difference between the plan\u2019s bid and Medicare\u2019s determination of a benchmark cost to provide the basic benefits in a given region).<\/p>\n<h3 class=\"rtejustify\"><strong>Changes to MAO Telehealth Benefits after the BBA<\/strong><\/h3>\n<p class=\"rtejustify\">Section 50323 of the BBA amends Section 1852 of the SSA, by adding subsection (m), \u201cProvision of Additional Telehealth Benefits.\u201d The additional benefits delineated in the new Section 1852(m) are defined as services: (1) \u201cfor which benefits are available under part B, including services for which payment is not made under section 1834(m) due to the conditions for payment under such section;\u201d and (2) \u201cthat are identified for such year as clinically appropriate to furnish using electronic information and telecommunications technology when a physician (as defined in section 1861(r)) or practitioner (described in section 1842(b)(18)(C)) providing the service is not at the same location as the plan enrollee.\u201d \u00a7 50323. The BBA did not define \u201cnot at the same location\u201d, and it is unclear how it will be interpreted. Capital and infrastructure investments and costs relating to these additional benefits are excluded. <i>Id<\/i>. Beginning calendar year (CY) 2020, MAOs may choose to provide these telehealth benefits, \u201cidentified as clinically appropriate\u201d by the Secretary, in their annual bids to CMS. If an MAO chooses to provide these additional benefits, the services will qualify as basic benefits, that is, \u201cattributable to the provision of benefits under the original [M]edicare fee-for-service program option,\u201d in the MAOs bid to CMS. \u00a7 1854(a)(6)(A)(ii)(I) of the SSA. This means that they do not have to be paid for as a \u201csupplemental\u201d benefit, either by separate premium or by rebate. The BBA also requires that MAOs that choose to offer Section 1852(m) telehealth services also offer an in-person visit benefit, with the enrollee maintaining the discretion to choose either the telehealth or in-person visit service. \u00a7 50323.<\/p>\n<h3 class=\"rtejustify\"><strong>Next Steps<\/strong><\/h3>\n<p class=\"rtejustify\">The BBA mandates that the Secretary of Health and Human Services determine the requirements \u201cfor the provision or furnishing of additional telehealth benefits,\u201d such as the requirements for physician or practitioner training and qualifications and the \u201cfactors necessary for the coordination of such benefits with other items and services including those furnished in-person.\u201d <i>Id<\/i>. The Secretary is required to solicit comments on these requirements, as well as the types of services that should be considered as additional telehealth benefits, as defined in the statute above, \u201cincluding those provided through supplemental health care benefits, such as remote patient monitoring, secure messaging, store and forward technologies, and other non-face-to-face communication,\u201d by November 30, 2018. <i>Id<\/i>. The BBA does not expressly specify the next steps required after the Secretary solicits public comments.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Earlier this year, President Trump signed into law the Bipartisan Budget Act of 2018 (BBA), [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":5193,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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