Medicare Advantage plans, ACOs, and physicians offering telehealth services stand to benefit from provisions set forth in the omnibus package.
In addition to providing several funding measures to federal healthcare programs, the bipartisan budget deal signed into law Friday by President Donald Trump also approved new regulations that could expand telehealth.
The two-year budget agreement widens telehealth options for Medicare Advantage plans and Accountable Care Organizations (ACOs), and it authorizes payments to physicians who furnish telehealth services starting in 2021.
"This legislation represents the first time physician payment has been enabled for the broad Medicare population and, we believe, marks the beginning of a shift in policy supportive of telehealth as a means to improve access and lower cost,” said Joseph M. DeVivo, CEO of InTouch Health, in a statement.
Currently, telehealth services are offered as separate items to patients visiting physicians who use the technology for treatment options. Under the new law, telehealth services covered by Medicare Advantage plans will change from being considered “additional telehealth benefits,” and instead be classified as benefits provided to patients at in-person visits.
This would bring the service in line with the original Medicare fee-for-service methodology.
The change to in-person telehealth benefits, which remains the patient’s choice of whether to accept, will take effect in 2020. According to the bill text, specifications for requirements on coordination of in-person telehealth benefits, physician qualification and training remains the duty of Secretary of Health and Human Services Alex Azar.
Additionally, the legislation clarifies the geographic definition for ACOs, including the home setting as a location for telehealth services to take place. Previously, ACOs had faced geographic limitations to the coverage of certain services provided, including telehealth.
Stroke patients are expected to benefit from the increased convenience of telehealth coverage, considering more than half a million strokes occur to Medicare enrollees per year. Telemedicine services are widely regarded as quick ways to administer potentially life-saving care for patients with severe medical conditions, including strokes.
The omnibus package incorporated several provisions of the CHRONIC Care Act, a bill to expand telehealth services that was passed in the Senate in September. It did not receive a floor vote in the House.
The inclusion of telemedicine language in the legislation was praised by telehealth advocates and a national physicians organization.
Better Medicare Alliance, an advocacy organization, has been working to expand service options for Medicare Advantage plans and views this budget deal as a win for enrollees in the program.
“Due to actions taken by Congress, Medicare Advantage plans now have greater flexibility to offer a wider array of supplemental benefits to address chronic conditions,” BMA President and CEO Allyson Y. Schwartz said in the statement. “There is greater opportunity for Medicare Advantage plans to include innovative technologies in telemedicine, and Medicare Advantage Special Needs Plans designed to provide team-based care for dual-eligible, chronically ill, and institutionalized beneficiaries now have the promise of stability to grow.”
Jack Ende, MD, MACP, President of the American College of Physicians, said the organization supports the inclusion of “provisions that will better facilitate chronic care management.”
In a statement, Ende said the legislation will lift geographic restrictions facing physicians furnishing telehealth consultation services while expanding coverage options for Medicare Advantage Plans and ACOs.
Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.