Background:
On July 16th, 2020, GIRS posted a blog article about the expansion of the telehealth services during the pandemic. The improvement of coverage and payment restrictions by Medicare as well as commercial payer for telehealth services have improved patient access. This Blog article tracks the initiatives to expand telehealth services beyond the pandemic.
Telehealth Expansion: The Executive Order:
On Monday, August 3, President Trump signed executive orders to expand telehealth services for Medicare beneficiaries and improve access to care in in rural America beyond the end of the current public health emergency (PHE).
What CMS is doing?
- On that same day, the Centers for Medicare & Medicaid Services (CMS) proposed to permanently allow telehealth evaluation and management services.
- temporarily continue emergency department (ED) visits by telehealth services.
- execute a multi-year endeavor to condense physician burden under the Patients Over Paperwork Initiative and to guarantee appropriate reimbursement for time consumed with patients.
- allow stakeholders’ comments on additional services that should be delivered by telehealth beyond the PHE.
Although the access to care varies regionally, the CMS efforts to expand coverage of telehealth services have improved patient access during the pandemic. Before the PHE in mid-March, only 14,000 Medicare beneficiaries received Medicare telehealth service in a week. In early-July, over 10.1 million beneficiaries have received a Medicare telehealth service during the PHE. These changes are proposed in multiple proposed rules.
What can you do?
If your technology or associated services can be utilized or delivered by telehealth, we can assist you to comment on the proposed rules listed below.
Comments on the proposed rules are due October 5, 2020:
For a fact sheet on the CY 2021 Physician Fee Schedule proposed rule, please visit:
For a fact sheet on the CY 2021 Quality Payment Program proposed rule, please visit: https://qpp-cm-prodcontent.s3.amazonaws.com/uploads/1100/2021%20QPP%20Proposed%20Rule%20Fact%20Sheet.pdf
For a fact sheet Medicare Diabetes Prevention Program-
To view the CY 2021 Physician Fee Schedule and Quality Payment Program proposed rule, please visit:
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Why partner with GIRS
The GIRS Payer Advocacy Compass PAC® team that includes a team of reimbursement lawyers, payer policy and payer advocacy experts has over 17 years of experience tracking payer policies and educating providers and stakeholders about changes to the policies to ensure coverage and reimbursement of our client’s medical technologies. Please contact us at info@girsinc.com or avail of our Complimentary Review of your reimbursement needs at girsinc.com
About GIRS
For more than 17 years, GIRS has been assisting medical technology manufacturers with their market uptake and reimbursement strategies so that patients can have access to the care that they need. To implement successful market access strategies, the GIRS Value Discovery Landscape Assessments® team and the Payer Advocacy Compass® team work together to develop and implement foundation reimbursement landscape and payer advocacy strategies to obtain positive coverage, appropriate payment, and innovative payer contracting arrangements to improve market uptake. . For more information, email us at info@girsinc.com or call us at 901-834-9119.