On April 5, officials at the federal Centers for Medicare & Medicaid Services (CMS) announced policy changes that will give Medicare Advantage participants expanded access to telehealth-delivered healthcare services.
As published on CMS’s website on Friday morning, the announcement began, “Today, the Centers for Medicare & Medicaid Services (CMS) finalized policies that will increase plan choices and benefits, including allowing Medicare Advantage plans to include additional telehealth benefits. These policies continue the agency’s efforts to modernize the Medicare Advantage and Part D programs, unleash innovation and drive competition to improve quality among private Medicare health and drug plans.
“Today’s policies represent a historic step in bringing innovative technology to Medicare beneficiaries,” said CMS Administrator Seema Verma in a statement contained in the press release. “With these new telehealth benefits, Medicare Advantage enrollees will be able to access the latest technology and have greater access to telehealth. By providing greater flexibility to Medicare Advantage plans, beneficiaries can receive more benefits, at lower costs and better quality.”
As the announcement noted, “The final policies announced today leverage new authorities provided to CMS in the Bipartisan Budget Act of 2018, which President Trump signed into law last year. CMS is finalizing changes that would allow Medicare Advantage beneficiaries to access additional telehealth benefits, starting in plan year 2020. These additional telehealth benefits offer patients the option to receive health care services from places like their homes, rather than requiring them to go to a healthcare facility. Before this year,” the announcement explained, “seniors in Original Medicare could only receive certain telehealth services if they live in rural areas. Starting this year, Original Medicare began paying for virtual check-ins across the country, meaning patients can connect with their doctors by phone or video chat.”
As the announcement noted, “Historically, Medicare Advantage plans have been able to offer more telehealth services, compared to Original Medicare, as part of their supplemental benefits. But with the final rule, it will be more likely that plans will offer the additional telehealth benefits outside of supplemental benefits, expanding patients’ access to telehealth services from more providers and in more parts of the country than before, whether they live in rural or urban areas.”
In the same announcement on its website, CMS also revealed that it was “finalizing changes that will make improvements to Medicare Advantage and Part D Star Ratings so that consumers can identify high-value plans. The final rule updates the methodology for calculating Star Ratings, which provide information to consumers on plan quality. The new Star Ratings methodology will improve the stability and predictability for plans, and will adjust how the ratings are set in the event of extreme and uncontrollable events such as hurricanes,” the agency stated.
The April 5 announcement came just four days after CMS’s April 1 announcement that it was changing its polices in the Medicare Advantage program around the social determinants of health (SDOH) elements in health status. Together, the announcements confirm a pattern of the expansion of coverage for a broader range of services and support for Medicare Advantage plan members nationwide.
