{"id":5532,"date":"2018-07-20T02:44:15","date_gmt":"2018-07-20T02:44:15","guid":{"rendered":"http:\/\/tele.healthcare\/?p=5532"},"modified":"2018-07-20T02:44:15","modified_gmt":"2018-07-20T02:44:15","slug":"cms-physician-payment-proposal-nudges-open-the-door-for-telehealth","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/cms-physician-payment-proposal-nudges-open-the-door-for-telehealth\/","title":{"rendered":"CMS physician payment proposal nudges open the door for telehealth"},"content":{"rendered":"<footer class=\"node__meta\">\n<div class=\"node__submitted\">by <a href=\"https:\/\/www.fiercehealthcare.com\/author\/evan-sweeney\">Evan Sweeney<\/a> |<\/p>\n<div><time datetime=\"2018-07-16T18:10:00Z\">Jul 16, 2018 2:10pm<\/time><\/div>\n<\/div>\n<\/footer>\n<div class=\"thumbnail-image\">\n<div><\/div>\n<div class=\"caption\">\n<div>CMS estimated that reimbursing for virtual check-ins would reach an estimated 19 million visits per year.<\/div>\n<\/div>\n<\/div>\n<div class=\"node__container\">\n<div class=\"social-container sticky-container\">\n<div><\/div>\n<div>Telehealth advocates are rejoicing over last week\u2019s physician payment proposal that would reimburse physicians for certain virtual interactions, a move that some see as a significant first step in overcoming the telehealth payment obstacle.<\/div>\n<\/div>\n<div class=\"node__content social-exists\">\n<p>Buried in the 1,473-page proposed rule released last week by the Center for Medicare &amp; Medicaid Services\u00a0are several new proposals to pay physicians for virtual check-ins and reviewing patient photos or videos using asynchronous or \u201cstore-and-forward\u201d transmission.<\/p>\n<p>CMS also proposed adding new billing codes for \u201cprolonged preventative services,\u201d along with three new remote monitoring reimbursement codes recommended by ACT, The App Association.<\/p>\n<section class=\"node node--type-embed-promo node--view-mode-body-embed-promo clearfix\" role=\"article\">\n<div class=\"promo_content clearfix\">\n<div>The healthcare sector remains in flux as policy, regulation, technology and trends shape the market. FierceHealthcare subscribers rely on our suite of newsletters as their must-read source for the latest news, analysis and data impacting their world. Sign up today to get healthcare news and updates delivered to your inbox and read on the go.<\/div>\n<\/div>\n<footer><\/footer>\n<footer>Jennifer Breuer, a partner with Drinker Biddle, said the proposed rule is a \u201cgame-changer\u201d for the telehealth industry if it is finalized in its current form.<\/footer>\n<\/section>\n<p>\u201cWhat this really would do is create some pretty broad-based reimbursement for telehealth services not just in rural locations and not just in a healthcare facility, as is currently the case,\u201d she told FierceHealthcare.<\/p>\n<p>It\u2019s clear CMS is still ironing out the details on the proposal. In its explanation of virtual check-ins, which would include basic telephone calls, the agency asked for industry input about what types of \u201ccommunication technology\u201d are utilized by physicians, whether or not to include frequency limitations and how physicians should document that the services are medically reasonable.<\/p>\n<p>CMS also noted that the proposal paves the way for new substance abuse treatment pathways, including virtual medication-assisted therapy.<\/p>\n<p>According to Mei Wa Kwong, executive director of the Center for Connected Health Policy, CMS was forced to perform some \u201cmental gymnastics\u201d to get around payments restrictions in Social Security Act, which limits telehealth payments to rural facilities.<\/p>\n<p>Using the term \u201ccommunication technology,\u201d the agency said the scope of the law is limited to \u201ca discrete set of physicians\u2019 services that ordinarily involve, and are defined, coded, and paid for as if they were furnished during an in-person encounter between a patient and a health care professional.\u201d<\/p>\n<p>\u201cWe all know this is telehealth, but they aren\u2019t technically calling it telehealth because they would be limited,\u201d Kwong said<\/p>\n<p>According to the proposal, Medicare would pay $14 per visit for virtual check-ins, a fraction of the cost of a $92 patient visit. Although CMS estimates it would pay for less than 1 million visits in the first year of the program, utilization would eventually reach an estimated 19 million per year.<\/p>\n<p>That 0.2% increase to Medicare costs would be offset by a 0.2% reduction in the \u201cconversion factor\u201d to maintain budget neutrality.<\/p>\n<p>Whether that payment is high enough to incentivize physicians to utilize virtual technology remains to be seen, but experts say it is added reimbursement for something many physicians are already doing.<\/p>\n<p>\u201cI think what we\u2019ve seen from hospital and health system clients, and others who have adopted telehealth already, they are finding different ways to incentivize physicians to participate,\u201d Breuer said.<\/p>\n<h3>An opening for direct-to-consumer companies<\/h3>\n<p>While all of the proposals revolve around virtual communications with an existing physician-patient relationship, CMS did throw a bone to direct-to-consumer telehealth providers.<\/p>\n<p>In outlining a new proposal that would pay providers that review asynchronous video or images captured by a patient, CMS asked for comments about whether there are certain cases\u2014such as dermatological or ophthalmological services\u2014where a prior relationship isn\u2019t necessary.<\/p>\n<p>\u201cFor example, when a patient seeks care for a specific skin condition from a dermatologist with whom she does not have a prior relationship, and part of the inquiry is an assessment of whether the patient needs an in-person visit, the patient could share, and the dermatologist could remotely evaluate, pre-recorded information,\u201d the proposal states.<\/p>\n<p>Although it was a request for information rather than a proposed rule, Kwong said it was notable since it diverged from traditional policies, and potentially offered some insight into how CMS plans to approach telehealth in the future.<\/p>\n<p>\u201cThat could help direct-to-consumer [companies],\u201d she said. \u201cDepending on what state you\u2019re in, there are ways to establish that via telehealth.\u201d<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>by Evan Sweeney | Jul 16, 2018 2:10pm CMS estimated that reimbursing for virtual check-ins 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