CMS Telehealth Policy Review: Seema Verma’s July 2020 Priorities

Historical Medicare policy context (July 2020; reviewed November 2026): This article summarizes then-CMS Administrator Seema Verma’s July 15, 2020 discussion of emergency telehealth expansions and policy questions, not rules governing current Medicare claims. The original Health Affairs analysis evaluated clinical appropriateness, reimbursement, and program integrity. The COVID-19 public health emergency has ended, and subsequent legislation extended many Medicare telehealth flexibilities through December 31, 2027, subject to applicable requirements. Consult HHS current policy guidance before relying on any coverage or payment statements below.

In response to the telehealth expansions and increased usage during the pandemic, CMS was reviewing the temporary regulatory changes it had made and assessing which might become permanent, according to then-CMS Administrator Seema Verma.

In a July 15 Health Affairs article, Ms. Verma addressed the benefits that telehealth expansions had offered during the pandemic and what challenges CMS was reviewing at the time to permanently expand provisions. At that time, the agency was examining the impact the temporary provisions have had on access to care, health outcomes, Medicare spending and the healthcare delivery system.

CMS lifted several regulations to expand telehealth during the public health emergency, including allowing Medicare beneficiaries across the U.S., not just those located in rural areas, to receive telehealth services and allowing 135 additional services to be covered when delivered via telehealth.

The following were three areas CMS was assessing when considering which telehealth flexibilities might be made permanent, according to Ms. Verma.

1. Mode of telehealth delivery and when virtual care is clinically appropriate and safe for patients as compared to an in-person visit. For example, during the pandemic, CMS has expanded telemedicine services to both new and established patients despite the services only previously being available to patients who had an established relationship with the provider.

2. Medicare payment rates for telehealth services, which have been increased to the same rate as in-person visits during the pandemic. There needs to be further analysis to identify the level of resources needed for telehealth visits outside of a public health emergency to determine potential payment rate adjustments. For example, supply costs such as gowns and disinfectants typically needed to support safe in-person care and are included in the in-person payment rate are not needed during a telehealth visit.

3. Telehealth fraud and abuse prevention. CMS is analyzing its data and monitoring providers’ telehealth programs’ integrity implications such as “practitioners who may be offering shorter telehealth visits with patients to maximize payment, or billing more visits than are possible in a day,” to ensure beneficiaries and taxpayer money is protected from potential bad actors.