CMS Finalizes MA Rule Incentivizing Provider Investments in Telehealth

The Centers for Medicare and Medicaid Services (CMS) finalized requirements seeking to increase access to telehealth for seniors in Medicare Advantage (MA) plans. The changes made to MA and Medicare Part D also expand supplemental benefit options for beneficiaries with chronic diseases.

CMS will grant MA plans more flexibility to offer and discount specialty care telehealth providers in areas such as dermatology, psychiatry, cardiology and primary care, allowing them to expand benefits and meet network adequacy standards.

“CMS’s rapid changes to telehealth are a godsend to patients and providers and allows people to be treated in the safety of their home,” CMS Administrator Seema Verma said in a statement.

The changes we are making will help make telehealth more widely available in Medicare Advantage and are part of larger efforts to advance telehealth.

The rule is the latest in the agency’s efforts to advance telehealth accessibility,  but home healthcare providers continue to struggle as they cannot seek reimbursement for telehealth visits under traditional, fee-for-service Medicare. Experts say it may present an opportunity for home health providers to take advantage of coordinated care models and work with specialty care providers.

CMS also announced changes to Medicare Part D including more emphasis on member feedback in the star rating methodology and lower out-of-pocket insulin costs for seniors. Nationwide, participating enhanced Part D prescription drug plans will offer beneficiaries access to a range of insulin at a $35 maximum copay for a month’s supply, beginning at the start of the year and continuing through the Part D coverage gap.

CMS estimates the changes made to MA plans and Medicare Part D will save the government $3.65 billion.

For the finalized rule, check out the CMS site. And check out this press release for the changes made to Medicare Part D.

Take a look at Home Health Care News and Modern Healthcare for more on the MA plan changes.

And also check out Fierce Healthcare’s reporting.