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CMS Finalizes Telehealth Policies to Increase Quality Care


The policies aim to expand telehealth access for patients, increase innovation and drive competition.


Photo has been modified. Courtesy of Home Dialysis Central.

The Centers for Medicare and Medicaid (CMS) finalized policies to bring innovative telehealth benefits to Medicare Advantage plans, according to last week’s announcement.

The policies are part of CMS’ efforts to modernize the Medicare Advantage and Part D programs and drive competition and innovation to improve quality among private Medicare health and drug plans.

Verma said that with the new telehealth benefits, Medicare Advantage enrollees will be able to access the latest technology. Beneficiaries could receive more benefits at lower costs and better quality.

The changes will allow Medicare Advantage beneficiaries to access additional telehealth benefits in 2020. The benefits will offer patients the option to receive healthcare services from their homes, rather than having to go to a healthcare facility.

Previously, seniors in Original Medicare could only receive certain telehealth services if they lived in rural areas. This year, Original Medicare started paying for virtual check-ins across the country so patients can connect with their physicians by phone or video call.

With the final rule, it is more likely that plans will offer additional telehealth benefits outside of the supplemental benefits, expanding patients’ access to telehealth services.

According to CMS, with the new telehealth and supplemental benefits, Medicare Advantage plans will have the flexibility to provide a historic set of offerings to beneficiaries.

The finalized telehealth policies come just days after the agency finalized updates to offer chronically ill patients a broader range of supplemental benefits that are not necessarily health-related and can address the social determinants of health.

CMS is also trying to make improvements to Medicare Advantage and Part D Star Ratings to allow consumers to identify high-value plans.

The final rule is supposed to improve the quality of care for beneficiaries dually eligible for Medicare and Medicaid who participate in Dual Eligible Special Needs Plans. The rule will create one appeals process across Medicare and Medicaid, to make it easier for enrollees in certain Dual Eligible Special Needs Plans to navigate the healthcare system and have access to high quality services.

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