CMS is focussing on increasing technological innovation and boosting competition among Medicare Advantage plans. Thus, it has decided to expand the range of beneficiaries eligible for telemedicine benefits.
The new rule will come to effect in the 2020 plan year and will allow Medicare Advantage to offer telehealth service as part of their basic benefit package. Patients will have more options to receive telehealth services from remote locations like their homes.
Telehealth benefits covered by CMS (Centers for Medicare & Medicaid Services) have been restricted to patients in rural areas with limited access to brick-and-mortar care facilities. But CMS has been expanding its offerings due to the growing trend of payers, moving from care delivery to lower cost and more convenient sites of care.
Medicare Advantage plans in the past were flexible about offering telehealth services under their supplemental benefits banner. Now, the new rule shifts these remote visits to the core part of the benefits covered by CMS.
This might prove to be a boon to telemedicine providers as MA has plans to make telemedicine a standard part of benefit offerings. Currently, MA plans cannot directly allocate federal dollars to telehealth services.
Along with the new telehealth benefits expansion, CMS has also extended the plan to cover benefits that address beneficiaries’ social determinants of health.
CMS Administrator Seema Verma said that, “the new telehealth benefits will let Medicare Advantage enrollees to access the modern technology and have greater access to telehealth”.