{"id":6889,"date":"2019-04-09T17:36:52","date_gmt":"2019-04-09T17:36:52","guid":{"rendered":"http:\/\/tele.healthcare\/?p=6889"},"modified":"2019-04-09T17:36:52","modified_gmt":"2019-04-09T17:36:52","slug":"cms-is-loosening-regulations-on-telehealth-services-offered-in-medicare-advantage-plans","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/cms-is-loosening-regulations-on-telehealth-services-offered-in-medicare-advantage-plans\/","title":{"rendered":"CMS is loosening regulations on telehealth services offered in Medicare Advantage plans"},"content":{"rendered":"\n<p>The Centers for Medicare and Medicaid Services (CMS) <a href=\"https:\/\/e.businessinsider.com\/click\/16518290.1323\/aHR0cHM6Ly93d3cuY21zLmdvdi9uZXdzcm9vbS9wcmVzcy1yZWxlYXNlcy9jbXMtZmluYWxpemVzLXBvbGljaWVzLWJyaW5nLWlubm92YXRpdmUtdGVsZWhlYWx0aC1iZW5lZml0LW1lZGljYXJlLWFkdmFudGFnZQ\/5bc4a934678089748b04a3b4B37252264\" target=\"_blank\" rel=\"noreferrer noopener\"> finalized<\/a> a rule <a href=\"https:\/\/e.businessinsider.com\/click\/16518290.1323\/aHR0cHM6Ly9pbnRlbGxpZ2VuY2UuYnVzaW5lc3NpbnNpZGVyLmNvbS9wb3N0L3VuaXRlZGhlYWx0aGNhcmUtdW52ZWlscy1uZXctZGlnaXRhbC1oZWFsdGgtZmVhdHVyZXMtY21zLWV4cGFuZHMtbWVkaWNhcmUtdGVsZWhlYWx0aC1zcXVhcmUtd2VpZ2hzLWxhcmdlci1yb2xlLWluLWhlYWx0aC1wYXltZW50cy0yMDE4LTEw\/5bc4a934678089748b04a3b4B1f665d45\" target=\"_blank\" rel=\"noreferrer noopener\"> proposed<\/a> in October 2018 that loosens regulations on <a href=\"https:\/\/www.businessinsider.com\/telehealth-industry-explained\"> telehealth services<\/a> offered in Medicare Advantage (MA) plans. <\/p>\n\n\n\n<p> For context, MA is a type of health insurance <a href=\"https:\/\/e.businessinsider.com\/click\/16518290.1323\/aHR0cHM6Ly9pbnRlbGxpZ2VuY2UuYnVzaW5lc3NpbnNpZGVyLmNvbS9wb3N0L3N0YXJ0dXBvc2NhcmhlYWx0aGltcGFzc2U\/5bc4a934678089748b04a3b4B3831ec2b\" target=\"_blank\" rel=\"noreferrer noopener\"> offered<\/a> by private insurers to consumers 65 and up as an alternative to the government&#8217;s traditional Medicare program. Membership in the private Medicare market grew around 6% year-over-year (YoY) in 2018 and is projected to tick up 12% YoY to reach an all-time high of <a href=\"https:\/\/e.businessinsider.com\/click\/16518290.1323\/aHR0cHM6Ly9pbnRlbGxpZ2VuY2UuYnVzaW5lc3NpbnNpZGVyLmNvbS9wb3N0L2x5ZnQtZXhwYW5kcy1tYWpvci1oZWFsdGgtaW5zdXJhbmNlLXBhcnRuZXJzaGlwcy1taWNyb3NvZnQtcmVsZWFzZXMtaGVhbHRoLWNoYXRib3Qtc2VydmljZS1hbWF6b24tYXBwbGUtaGVhbHRoLXN0YWZmaW5nLXJvdW5kdXAtMjAxOS0y\/5bc4a934678089748b04a3b4B5b24ed24\" target=\"_blank\" rel=\"noreferrer noopener\"> 23 million<\/a> members in 2019, making it an attractive market for private payers. <\/p>\n\n\n\n<p><strong> He<\/strong><strong>re&#8217;s what it means:<\/strong> The new rule extends telehealth benefits previously offered by MA plans, making them cheaper and more accessible. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li> The policy lifts geographic restrictions that were likely limiting telehealth adoption. Previously, regulation only allowed MA plans to receive reimbursement for offering telehealth services with a caveat: Beneficiaries were required to travel to designated healthcare facilities in order to access them. Now, MA members can access telehealth services regardless of their location.     <\/li><li> And it broadens telehealth reimbursement for payers. Before, insurers could only offer telehealth as a supplemental benefit paid for with rebates or beneficiary premiums, <a href=\"https:\/\/e.businessinsider.com\/click\/16518290.1323\/aHR0cHM6Ly93d3cubW9kZXJuaGVhbHRoY2FyZS5jb20vY2FyZS1kZWxpdmVyeS9jbXMtZXhwYW5kcy1tZWRpY2FyZS1hZHZhbnRhZ2UtdGVsZWhlYWx0aC1iZW5lZml0cw\/5bc4a934678089748b04a3b4Bd0a515d6\" target=\"_blank\" rel=\"noreferrer noopener\"> per<\/a> Modern Healthcare. MA plans can now include telehealth as a generic government-funded benefit.     <\/li><\/ul>\n\n\n\n<p><strong>The bigger picture:<\/strong> The CMS&#8217; move to augment telehealth services could help spur rapid growth in telemedicine adoption. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li> Payers will likely beef up their private Medicare plans with telehealth offerings. A clearer path to reimbursement should prompt more insurers to cover telehealth services, especially given the potential for savings: Health system Spectrum Health&#8217;s uptick in telehealth offerings saved payers <a href=\"https:\/\/e.businessinsider.com\/click\/16518290.1323\/aHR0cHM6Ly9pbnRlbGxpZ2VuY2UuYnVzaW5lc3NpbnNpZGVyLmNvbS9wb3N0L2NoYXRib3QtcGF0aWVudC1lbmdhZ2VtZW50LXBsYXRmb3JtLXJhaXNlcy02LW1pbGxpb24tdGVsZWhlYWx0aC1zYXZlcy1pbnN1cmVycy0xNS1taWxsaW9uLXVrLWJldHMtb24tYWktZm9yLWNocm9uaWMtZGlzZWFzZS10cmVhdG1lbnQtMjAxOC01\/5bc4a934678089748b04a3b4B51bd8a59\" target=\"_blank\" rel=\"noreferrer noopener\"> $1.5 million<\/a> in the first half of 2018 alone, for example.     <\/li><li> Growth in MA membership should further boost telehealth adoption. MA enrollees will account for <a href=\"https:\/\/e.businessinsider.com\/click\/16518290.1323\/aHR0cHM6Ly93d3cua2ZmLm9yZy9tZWRpY2FyZS9pc3N1ZS1icmllZi9hLWRvemVuLWZhY3RzLWFib3V0LW1lZGljYXJlLWFkdmFudGFnZS8\/5bc4a934678089748b04a3b4B03d83ed5\" target=\"_blank\" rel=\"noreferrer noopener\"> 42%<\/a> of total Medicare membership by 2028 \u2014 up from 34% in 2018 and 22% in 2008, per the Kaiser Family Foundation. Over the same period, Medicare enrollment will grow <a href=\"https:\/\/e.businessinsider.com\/click\/16518290.1323\/aHR0cHM6Ly9pbnRlbGxpZ2VuY2UuYnVzaW5lc3NpbnNpZGVyLmNvbS9wb3N0L3RoZS13ZWFyYWJsZXMtaW4tdXMtaGVhbHRoY2FyZS1yZXBvcnQtaG93LWluc3VyZXJzLXByb3ZpZGVycy1hbmQtZW1wbG95ZXJzLWNhbi1oYXJuZXNzLW5ldy1tYXJrZXQtb3Bwb3J0dW5pdGllcy11c2luZy13ZWFyYWJsZXMtMjAxOC04\/5bc4a934678089748b04a3b4Bc948000f\" target=\"_blank\" rel=\"noreferrer noopener\"> steadily<\/a> as the US population ages <a href=\"https:\/\/e.businessinsider.com\/click\/16518290.1323\/aHR0cHM6Ly9pbnRlbGxpZ2VuY2UuYnVzaW5lc3NpbnNpZGVyLmNvbS9wb3N0L3RoZS13ZWFyYWJsZXMtaW4tdXMtaGVhbHRoY2FyZS1yZXBvcnQtaG93LWluc3VyZXJzLXByb3ZpZGVycy1hbmQtZW1wbG95ZXJzLWNhbi1oYXJuZXNzLW5ldy1tYXJrZXQtb3Bwb3J0dW5pdGllcy11c2luZy13ZWFyYWJsZXMtMjAxOC04\/5bc4a934678089748b04a3b4Cc948000f\" target=\"_blank\" rel=\"noreferrer noopener\"> rapidly<\/a>.     <\/li><li> And this latest CMS policy could be a precursor to increased legislation favoring telehealth. Stringent government policies have historically been a primary <a href=\"https:\/\/e.businessinsider.com\/click\/16518290.1323\/aHR0cHM6Ly9pbnRlbGxpZ2VuY2UuYnVzaW5lc3NpbnNpZGVyLmNvbS9wb3N0L3RoZS11cy10ZWxlaGVhbHRoLW1hcmtldC1yZXBvcnQtdGhlLW1hcmtldC1kcml2ZXJzLWFuZC10aHJlYXRzLWFuZC1vcHBvcnR1bml0aWVzLWZvci1pbmN1bWJlbnRzLWFuZC1uZXdjb21lcnMtMjAxOC0y\/5bc4a934678089748b04a3b4Be94253c8\" target=\"_blank\" rel=\"noreferrer noopener\"> barrier<\/a> to broader telehealth adoption. This CMS policy \u2014 alongside laws recently <a href=\"https:\/\/e.businessinsider.com\/click\/16518290.1323\/aHR0cHM6Ly9pbnRlbGxpZ2VuY2UuYnVzaW5lc3NpbnNpZGVyLmNvbS9wb3N0L2NvbmdyZXNzLWhhcy1iaWctcGxhbnMtZm9yLXRlbGVtZWRpY2luZS1vbmxpbmUtcmV2aWV3cy1leHBvc2UtcGF0aWVudC1leHBlcmllbmNlLXdvZXMtbWljcm9zb2Z0LXJlbGVhc2VzLW9wZW4tc291cmNlLWNsb3VkLXByb2plY3QtMjAxOC0xMQ\/5bc4a934678089748b04a3b4Bb682f792\" target=\"_blank\" rel=\"noreferrer noopener\"> laid out<\/a> by Congress \u2014 signal a government mandate to increase telehealth adoption. If the CMS and other government agencies continue to relax telehealth regulation, healthcare players will be better positioned to fuel a telehealth boom. <\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<p>The Centers for Medicare and Medicaid Services (CMS) finalized a rule proposed in October 2018 [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":5487,"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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