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medicare Archives - National Consortium of Telehealth Research Centers

2019 in Review: State and Federal Telehealth Policy – Legislative Roundup

By | Center for Connected Health Policy

Original Source: Center for Connected Health Policy

 

It was an active year for state telehealth legislation in 2019.  Among 35 states, 113 legislative bills passed in the 2019 legislative session, up significantly from 65 bills in 2018.  Additionally, 54 telehealth related regulations were finalized in 35 states related to telehealth.  The large leap in the numbers of bills passed, was partially due to the increased passage of cross-state licensing legislation enacting interstate licensing compacts.  While the cross-state licensing topic area had 10 bills enacted in 2018, it more than doubled to 23 bills in 2019.  There was also large increases in the passage of bills establishing telehealth demonstrations, pilots and grant programs, as well as bills addressing regulatory professional board practice standards and prescribing. Bills related to both Medicaid and private payer reimbursement also both had an increase since 2018, although the number of bills passed has remained low comparatively.  CCHP’s 2019 roundup of state approved legislation, which includes a detailed listing of all bills by topic area and state, is now available.

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Updated 50 State Telehealth Laws & Reimbursement Policies Report

By | Center for Connected Health Policy

Original Source: Center for Connected Health Policy

 

An updated Fall 2019 version of CCHP’s “State Telehealth Laws and Reimbursement Policies” Report is available today!  The Fall 2019 edition offers policymakers, health advocates and other interested health care professionals a detailed compendium of state telehealth laws, regulations and Medicaid policies.  The report also includes an executive summary, which summarizes CCHP’s findings along with an “At a Glance” Infographic and Chart that highlights key data points from the report.  CCHP’s online interactive map tool has also been updated with all of the newest information from this update.

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Medicare Proposed 2020 PFS & California Medicaid Policy

By | Center for Connected Health Policy

Original Source: Center for Connected Health Policy

 

Medi-Cal Telehealth Fee-For-Service Policy Update

On July 29, 2019, the California Department of Health Care Services (DHCS) which oversees the state’s Medicaid program (Medi-Cal), released their final telehealth policy update for fee-for-service.  In October 2018, DHCS released proposed changes to telehealth policies for Medi-Cal fee-for-service, Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Indian Health Services (IHS) and Family Planning, Access, Care and Treatment (FPACT).  A copy of the final fee-for-service policy is available on the DHCS website though it is still labeled “DRAFT.”  The Department states that while this is the final policy, the official version of the policy will be published on their site later this month along with the updated manuals for FQHCs, RHCs, IHS, and FPACT.  When all manuals have been released, CCHP will do an in-depth analysis of all of the new policies.  In the meantime, CCHP has created a side-by-side comparison of Medi-Cal’s previous policy, the October 2018 proposal and the final proposal as well as highlighting some of the changes in the final policy.

CCHP will also be holding an informational webinar in the Fall to go over these exciting changes in Medi-Cal’s policies.  Stay tuned for more information.

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CMS Drops 2019 Telehealth Fact Sheet for Medicare

By | Center for Connected Health Policy

Original Source: Center for Connected Health Policy

The Center for Medicare & Medicaid Services (CMS) recently released its 2019 Medicare Fact Sheet for Telehealth Services which outlines what services the program will reimburse if delivered via telehealth.  The 2019 Fact Sheet outlines the changes that were made by two pieces of legislation passed in 2018, the Bipartisan Budget Act of 2018 (BBA) and the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (Support Act).  Both Acts expanded where services delivered via telehealth could take place.
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Federal Bill Aims to Expand Medicare Reimbursement for Mental Health Telehealth Services

By | Center for Connected Health Policy

Original Source: Center for Connected Health Policy

In late December 2018 US Senator Kamala Harris’ office announced through a press release that she would be introducing two bills aimed at increasing access to mental health services, one of which would expand Medicare reimbursement for mental health services provided through telemedicine.  The bill, introduced in the 115th Congress (2017-2018 Legislative Session) as S. 3797 and is titled the “Mental Health Telemedicine Expansion Act”, would define mental health telehealth services as those covered by CPT codes 90834 and 90837, both of which describe individual psychotherapy. These services are already covered by Medicare when delivered via live video, but are currently subject to Medicare’s originating site and geographic restrictions.
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2019 KICKS OFF WITH EXPANDED REIMBURSEMENT ANTICIPATED IN MEDICARE ACOs & CA MEDICAID (Medi-Cal)

By | Center for Connected Health Policy

Original Source: Center for Connected Health Policy

ACO Telehealth Expansion in Medicare Shared Savings Program

As required by the Bipartisan Budget Act, CMS has finalized their rule to broaden telehealth reimbursement for Medicare Accountable Care Organizations (ACOs) in the Shared Savings Program under the BASIC track (under a two sided model) and ENHANCED track when the ACO elects prospective assignment.  The finalized regulation allows eligible physicians and practitioners in the applicable ACOs to be reimbursed regardless of the geographic location of the patient and allows the home to be the originating site.  If the home was the originating site, there would be no facility fee allowed.  Other locations, besides the patient’s place of residence, would not qualify for reimbursement under the new rule, such as a school.  Other Medicare telehealth requirements would still apply, such as provider type and service code limitations.  Additionally, CMS also clarifies in the rule that in the case where the beneficiary’s home is the originating site, Medicare will not pay for telehealth services that are inappropriate to be furnished in the home even if the services are on the approved list of telehealth services, such as inpatient hospital visits.  The change would not be applicable until plan year 2020.

To learn more, read the full text of the rule.

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