For those enrolled in Medicare Advantage (MA) plans, good news is headed your way. In fall 2018, following the passage of the Bipartisan Budget Act (as we reported at the time) earlier that year, the Center for Medicare and Medicaid Services (CMS) proposed a rule that would allow MA plans to include more telehealth options. About six months later, as Business Insider and others recently highlighted, the rule is now finalized and soon to be implemented in the MA plans. After seeing how popular MA plans have become to consumers 65 and up—it is estimated that 23 million people will use them in 2019—CMS needed to update policies. “These additional telehealth benefits offer patients the option to receive health care services from places like their homes, rather than requiring them to go to a health care facility,” the agency said in a recent press release.
Under the old MA rules, members could receive telehealth
services as a part of their plans…but with a familiar catch: they had to travel
to designated health care facilities. However, under the new rule, members can
access telehealth from any location, including their homes. Additionally, the
new rule changes the way payers can be reimbursed for using telehealth services, since, as
Insider explains, “MA plans can now
include telehealth as a generic government-funded benefit.” It is no longer
considered a supplemental benefit. These new changes help to make telehealth
more accessible to members as well as more affordable. Simply put, it’s a
win-win for everyone.
Many view CMS’ new rule as a crucial part of the push needed to promote expanded telehealth use. Since more telehealth services can be covered through insurance, payers are more likely to include telehealth in their plans. Further, because reimbursement options are now broadened, insurers will be more likely to cover telehealth services. The additional savings are a huge incentive, too. As Business Insider highlights, “Health system Spectrum Health’s uptick in telehealth offerings saved payers $1.5 million in the first half of 2018 alone, for example.” The savings are only projected to continue rising. Furthermore, the new CMS policy could be a sign of more telehealth-friendly legislation to come—legislation that could expand coverage for all Medicare beneficiaries. For now, this is good news for MA members who could greatly benefit from the expanded telehealth options. Click here to read the Business Insider article on the new CMS telehealth rule.