CMS Proposes to Make Telehealth Flexibilities Permanent

At the close of June 2020, the Centers for Medicare & Medicaid Services (CMS) released a new proposed rule that would make some of the recent flexibilities for telehealth permanent. Many of these changes are already in place, though temporarily for now, in response to the COVID-19 Public Health Emergency. If finalized, this rule would make several of these new telehealth flexibilities permanent. This blog will provide you with a summary of the proposed rule so that you can stay informed on what it could mean for you and your practice.

Telehealth Use is Not Going Anywhere

Starting January 1, 2021, CMS proposes to make permanent some of the changes to telehealth that were initiated in response to the COVID-19 Public Health Emergency (PHE). Specifically, it proposes to make permanent the loosened restrictions on telehealth use for home health providers, such as remote patient monitoring. Providers will be required to outline the technology being used in the patient’s care plan and tie it to a specific treatment goal and relate it to skilled services being provided.

For now, the proposed rule does not offer any specifics when it comes to reimbursement methods for telehealth after the PHE has ended. However, it is very likely that once the rule is finalized, reimbursement details for telehealth will be included. CMS does not have the authority to include those measures, so it will be up to Congress to do so when the time comes.

Updates to Home Health Prospective Payment System (HH PPS)

If finalized, this rule would also bring the following updates to the HH PPS payment rates and wage index for 2021:

• 6% increase in Medicare payments to home health agencies (double the previous year’s increase of 1.3%).
• Limit of decreases to the home health wage index. Decreases in a geographic regions wage index value can be no more than 5% in 2021.

The above changes will amount to an additional $540 million in home health/telehealth Medicare and Medicaid reimbursements for 2021.

Home Infusion Therapy Service Update

This rule would also finalize changes to the home health infusion therapy benefit that was established by the 21st Century Cures Act. Starting January 1, 2021, it would allow Medicare beneficiaries to receive drugs intravenously or subcutaneously at home. This benefit is intended to be a separate payment that covers professional services, training/education that are not covered under the Durable Medical Equipment benefit, and monitoring/remote monitoring services for providing at-home infusion drugs. Therefore, these are excluded from coverage under the separate home health benefit.

This measure will encourage the continued use of telehealth for post-op, follow up care and at-home pain management services.

Readers should note that these updates are still in the proposed stage and have yet to be finalized. It is also important to understand that CMS has not made any policy changes to what was announce in last year’s final rule.

As regulations and technology advance, telehealth will continue to become a more regular part of the healthcare landscape. To learn more about how recent events have catapulted the industry into the Age of Telehealth, check out our new whitepaper.

To learn more about how Nextech can assist your practice in getting the most out of reimbursements and create a long-term strategy for overall success, fill out this form and a member of our team will be in touch soon.