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Just as policy is changing at the federal level to allow – and even encourage – greater use of telehealth and telemedicine programs, states, too, have been active. A number of states are in the process of updating telehealth laws and regulations, modernizing definitions to keep pace with available technology and services and setting rules for providers and plans.

Recent policy changes by the U.S. Department of Health and Human Services Center for Medicare and Medicaid Services (CMS) have been designed to make telehealth services more broadly available to Medicare beneficiaries. The changes follow a Congressionally-mandated report highlighting how reimbursement restrictions limit telehealth use, and so requirements have been relaxed for the Medicare Fee-For-Service effective January 1, 2019. Policy changes are pending for Medicare Advantage (MA) plans, effective for the 2020 plan year.

New telehealth benefits will be available for Medicare Advantage (MA) members if a proposed rule published November 1, 2018 by the Department of Health and Human Services Center for Medicare and Medicaid Services (CMS) becomes final, as expected. The rule implements provisions of the Bipartisan Budget Act of 2018, effective for plan year 2020.

The New Year is off to a good start for those involved in telehealth as changes to the Medicare Fee-For-Service program will bring expanded services to beneficiaries needing care related to stroke, End Stage Renal Disease (ESRD) and substance use disorder (SUD) and co-occurring mental health disorders.

CMS has published several proposed and final rules regarding the reimbursement of telehealth services that will have a major impact on providers and beneficiaries. This blog will discuss some of the major changes to Medicare FFS, effective January 1, 2019. Proposed changes to Medicare Advantage will be discussed in a later blog.