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

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 designs, improved quality, and choices for patients.

CMS took significant action to increase MA plan choices for the 2019 plan year and aims to continue to expand opportunities so that patients have access to MA plans that meet their unique health…

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 for ACOs that drew from focus groups and interviews with representatives from 21 ACOs. The organizations participated in the Shared Savings Program, the Next Generation ACO Model, and the…

Medicare coverage for telehealth has expanded but still has limits

The expansion of telehealth is changing the landscape of health care. This is the second in a four-part series exploring what providers should know about this growing area.

Before 2015, Medicare did not pay separately for telehealth, and telehealth and telemedicine services were bundled into “evaluation and management” codes. However, in 2015, the Center for Medicare & Medicaid Services (CMS) added further telehealth coverage. CMS has added seven telehealth billing codes, including codes for psychotherapy, prolonged office visits and annual wellness visits conducted electronically. CMS also began paying for remote patient monitoring for chronic…

CMS Updates MA Flexibility to Allow Telehealth Patient Care Access

The rule updates give Medicare Advantage plans the flexibility to offer telehealth as a covered benefit, boosting patient care access.

By Sara Heath

April 09, 2019 – CMS has finalized updates that would introduce telehealth as a covered benefit in Medicare Advantage plans, which will ideally improve patient care access.

This move comes as a part of the agency’s efforts to drive innovation in the Medicare program, create plan flexibility, and drive patient access to care, according to CMS Administrator Seema Verma.


CMS Finalizes Telehealth Expansion for Medicare Advantage Plans

CMS has finalized new rules unveiled last year that will expand telehealth access and reimbursement for the growing number of Americans in Medicare Advantage plans – and their doctors.

By Eric Wicklund

April 08, 2019 – The Centers for Medicare & Medicaid Services has finalized its plan to expand telehealth access and coverage in Medicare Advantage plans.       

In a Friday afternoon announcement, CMS said new rules will eliminate geographical restrictions on telehealth access and telemedicine services in MA plans by 2020, enabling those in urban areas to…

New CMS ruling expands telehealth access to Medicare Advantage patients

The new ruling will expand access geographical and plans will have more flexibility in payment models.

By Laura Lovett

Come 2020, Medicare Advantage (MA) members will have more access to virtual care visits, according to a new ruling from the Centers for Medicare and Medicaid Services that was finalized on Friday. The new ruling will expand geographical areas covered and the way the services are paid for. 

“Under this final rule, MA enrollees may have great opportunities to receive healthcare services from places like their homes,…

CMS expands Medicare Advantage coverage of telehealth services

The new rule, which will go into effect in the 2020 plan year, will allow Medicare Advantage to offer telehealth services as part of their basic benefits, providing patients more options to receive healthcare services from locations like their home.

By Kevin Truong / Apr 7, 2019 at 2:47 PM

As part of effort by CMS to increase technological innovation and boost competition among Medicare Advantage plans, the agency is moving to expand the range of beneficiaries eligible for telemedicine…

Home Care Providers Look Ahead as Medicare Advantage Evolution Continues

Home care providers slow to chase Medicare Advantage business opportunities may now be motivated to speed up their pursuits.

Last week, the Centers for Medicare & Medicaid Services (CMS) announced it was broadening the range of supplemental benefits Medicare Advantage (MA) plans can offer in 2020. Starting next year, health care policymakers will allow MA plans to cover any benefits that “have a reasonable expectation of improving or maintaining the health or overall function” of beneficiaries with chronic conditions.

While the language is brief, its implications are enormous, CareLinx President…

More Telehealth Benefits Coming To Medicare Advantage Plans In 2020

Access to telehealth services for seniors got another boost Friday when the Centers for Medicare & Medicaid Services said it would allow private Medicare Advantage plans to offer additional access to virtual doctors in their basic benefit packages.

The so-called final rule will bring new benefits to seniors in 2020 as part of their Medicare Advantage plans. Such coverage is growing rapidly and expected to account for half of Medicare beneficiaries in the coming years, some analysts say.

“Historically, Medicare Advantage plans have been able to…

CMS finalizes policies to bring innovative telehealth benefit to Medicare Advantage

CMS finalizes policies to bring innovative telehealth benefit to Medicare Advantage
Final Rule will strengthen popular Medicare private health insurance plans, expand telehealth access for patients, and improve coordination for dual-eligible individuals

Today, the Centers for Medicare & Medicaid Services (CMS) finalized policies that will increase plan choices and benefits, including allowing Medicare Advantage plans to include additional telehealth benefits. These policies continue the agency’s efforts to modernize the Medicare Advantage and Part D programs, unleash innovation and drive competition to improve quality among private Medicare health and drug plans.


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