fbpx Skip to main content

BioCommunique Article

CMS looks to make current telehealth reimbursement policy permanent as patients rely on telehealth services much more frequently.

COVID-19 Speeds Adoption of Telehealth and Reimbursement in U.S.

  • 2020-07-09T19:00:00.000+0000
  • California
  • Author: Hull Associates

The explosion of telehealth services that has accompanied the COVID-19 pandemic may lead to a permanent reliance on these services, following the June 26th Centers of Medicare & Medicaid Services (CMS) proposed rule to make permanent the changes to telehealth services reimbursed under the Medicare home health benefit beyond the expiration of the declared public health emergency (PHE) for COVID-19.

“We fully expect the trend towards telehealth and other remote technologies to continue,” said Stephen Hull, President and Founder of Hull Associates, a global market access and reimbursement consulting firm. “CMS has just made good on the promises of Administrator Seema Verma that the world is not going to go back from this big step forward.”

The proposed rule will make permanent telehealth regulations outlined in the COVID-19 Public Health Emergency Interim Final Rule, published at the end of March. Beginning on January 1st, 2021, Home health agencies (HHAs) can continue to utilize telehealth services in providing care to beneficiaries under the Medicare home health benefit beyond the end of the COVID-19 PHE.

The rule proposes routine, statutorily required updates to the home health payment rates for CY2021. CMS estimates that Medicare payments to HHAs in CY2021 would increase in by 2.6%, or $540 million. One analysis suggested a 64% year-over-year increase in related telehealth claims in 2020.

This proposed rule comes after the release earlier this month by CMS of preliminary COVID-19 Medicare claims data shows a disproportionate impact on end stage renal disease (ESRD) patients, and an overall mortality rate among Medicare beneficiaries of 28%.

The snapshot of data published by CMS indicates ESRD patients accounted for almost 73% of reported COVID-19 Medicare cases, and almost 81% of Medicare hospital admissions. In total, 1,341 ESRD Medicare beneficiaries were hospitalized with a diagnoses of COVID-19 per 100,000 Medicare hospital admissions, almost 10 times the number of aged or disabled beneficiaries, who represented 167 and 150 hospitalizations per 100,000, respectively.

Key changes implemented earlier by CMS include:

  • Waived requirements regarding the types of practitioners who may be reimbursed by Medicare for telehealth services.
  • Increased reimbursement for telehealth services to be more in line with reimbursement for in-person services, retroactive to March 1, 2020.
  • Allowing certain telehealth services to be provided via audio only, versus through both audio and video.

Hull Associates is a key resource for medical device, in vitro diagnostics and specialty pharma manufacturers for insight into reimbursement and market access. Please contact them for further information.

Contact Information: Eric Lam, PhD, Director of Market Access, Hull Associates LLC; 781-982-8600, Ext. 213

Hull Associates LLC is a global market access and reimbursement firm with a headquarters near Boston, MA. www.hullassociates.com.