Category: Reimbursement

CMS Issues Final Rule for Telehealth

Monday, May 13, 2019 Citing the use of telehealth as a care delivery option for Medicare Advantage (MA or Part C) enrollees with the potential to “improve access to and timeliness of needed care, increase convenience for patients, increase communication between providers and patients, enhance care coordination, improve quality...

CMS Announces Final Rules for Medicare Advantage Telehealth Benefits

On April 5, 2019, CMS issued final rules (the Final Rule) implementing various provisions of the 2018 Bipartisan Budget Act (the 2018 Budget).  The 2018 Budget includes provisions allowing Medicare Advantage plans to provide telehealth benefits as basic benefits, which are paid for by the Medicare program, rather than...

U.S. health officials unveil experiment to overhaul primary care

By Casey Ross @caseymross Federal health officials on Monday unveiled a new primary care experiment that seeks to pay doctors for providing stepped-up services that keep patients healthy and out of the hospital, an effort they say will transform basic medical services for tens of millions of American patients....

CMS Final Rule Offers the Promise of Additional Telehealth Services for MA Plan Enrollees

The Centers for Medicare & Medicaid Services (“CMS”) has published a final rule that will expand access to telehealth services for Medicare Advantage (“MA”) plan enrollees.CMS Administrator Seema Verma characterized the agency’s latest policymaking efforts as “a historic step in bringing innovative technology to Medicare beneficiaries” and a way for the agency to...

Contract Year 2020 Medicare Advantage and Part D Flexibility Final Rule (CMS-4185-F)

Contract Year 2020 Medicare Advantage and Part D Flexibility Final Rule (CMS-4185-F) On April 5, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates the Medicare Advantage (MA or Part C) and Medicare Prescription Drug Benefit (Part D) programs by promoting innovative plan...

CMS Shares Strategies for Successful Collaborations Between ACOs, Nursing Homes

The federal government released a breakdown of strategies that accountable care organizations (ACOs) have used to successfully partner with skilled nursing facilities — a move that could indicate policymakers’ continued support of the care models. The Centers for Medicare & Medicaid Services (CMS) recently released a care coordination toolkit...

CMS Expands Telehealth Benefits under Medicare Advantage

On Friday, April 5, 2019, the Centers for Medicare and Medicaid Services (“CMS”) announced that it had finalized policies allowing Medicare Advantage plans (“MA Plans”) to include additional telehealth benefits in their basic benefit packages starting in 2020.  The final rule implementing the changes (the “Final Rule”) will be published in...

Providers pushing for more telehealth flexibility after CMS opens up virtual visits to Medicare Advantage plans

Providers will be able to offer more telemedicine services to seniors in private Medicare plans, thanks to changes announced Friday. But nursing home advocates are pushing for more, hoping the technology can help ease the industry’s ongoing staffing challenges. Under the final rule starting in plan year 2020, nursing...

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