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CMS on Thursday made permanent changes to telehealth flexibilities for home health providers.

In its home health payment rule for 2021, the agency signed off on changes to allow providers to use telehealth for related skilled services if they’re outlined in a patient’s care plan. It also requires provides to describe how telehealth would improve treatment in a patient’s medical record. CMS bumped pay for home health providers by 1.9%, or about $390 million.

“The use of technology may not substitute for an in-person home visit that is ordered on the plan of care and cannot be considered a visit for the purpose of patient eligibility or payment,” according to a CMS fact sheet.

The agency also rubber-stamped a 5% cap on wage index cuts for 2021 and changes to home infusion therapy that must go into effect by Jan. 1 under the 21st Century Cures Act. CMS based its changes to 2021 payment rates for home infusion therapyservices on the 2021 physician fee schedule, leading to a 0.7% decrease to home infusion suppliers—a cut of about $385,000.

The rule takes effect Jan. 1.

Home health providers largely supported CMS’ plans to cover telehealth, saying the rule would expand access to care, especially in rural areas. But the jury is still out on whether telehealth improves patient care, said the Medicare congressional advisory group MedPAC in its comments on the proposed rule. The group worried greater telehealth flexibilities could make Medicare more vulnerable to misuse or lead to lower access to in-person care for enrollees.

Congress created a new home infusion therapy benefit under the Cures Act to allow Medicare beneficiaries to receive drugs or biologicals at home intravenously or subcutaneously. 

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