New Medicare Advantage Rule Expands Telehealth Access

Starting in the plan year for 2020, Medicare Advantage (MA) beneficiaries living in both rural and urban areas will have enhanced access to telehealth services that doesn’t require them to travel to a designated healthcare facility. The Trump administration finalized a new policy extending telehealth access.

Under this final rule, “MA plans will be permitted to offer—as part of the basic benefit package—additional telehealth benefits beyond what is currently allowable under the original Medicare telehealth benefit. In addition, MA plans will continue to be able to offer MA supplemental benefits (that is, benefits not covered by original Medicare) via remote access technologies and/or telemonitoring for those services that do not meet the requirements for coverage under original Medicare or the requirements for MA additional telehealth benefits,” the rule states.

Prior to this update, individuals on traditional Medicare plans were only eligible for telehealth services if they lived in rural areas.

This change is expected to boost the profile of telehealth for this population and the prevalence of telehealth services in general.

“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,” CMS Administrator Seema Verma said in a statement.

Additionally, the rule also expands Medicare’s ability to pay for services aimed at addressing social determinants of health. This includes flexibility for reimbursement to cover adult care programs and the installation of home safety devices like grab bars and wheelchair ramps, MedCity News reported.

Mary Butler is associate editor at Journal of AHIMA.

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