Medicare Proposes (and Rejects) New Telehealth Services for 2019

Medicare Proposes (and Rejects) New Telehealth Services for 2019

The telemedicine industry was pleased to learn CMS recently proposed adding new services to its list of Medicare-covered telehealth services.  But what may be more interesting are the services CMS declined to add, and why.  This article summarizes the newly-proposed additions as well as the services CMS rejected, explores some reasons for CMS’ decisions, and describes how industry advocates can submit comments to CMS and make their voice heard on these new proposals.  The public…

Final rule pushes interoperability, reduced reporting burden

The Centers for Medicare & Medicaid Services (CMS) has finalized a rule it says will improve interoperability, reduce the reporting burden under meaningful use, and allow healthcare providers to spend more time with their patients while saving hospitals and other medical facilities millions of dollars each year.
CMS said the final rule, announced last Thursday, will “put patients first, ease provider burden, and make significant strides in modernizing Medicare.”
The rule updates Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) to encourage value-based, quality care.
CMS also…

Reducing unnecessary hospitalization

Rep. Adrian Smith

Aug 4, 2018

Caring for the elderly and disabled among us is one of our most sacred responsibilities. Many of us have family or friends living in skilled nursing facilities and we want them to have access to the best care available in the event of an emergency.

Unfortunately, this is not always the case. Despite the availability of new technologies and qualified medical professionals in nursing facilities, seniors and the disabled across our country are frequently transported to hospital emergency rooms to receive emergency care. In fact, around 19 percent of hospital transfers come from skilled nursing facilities…

2018 Mid-Year Digital Health Report: Focus on Medicare

Monday, July 30, 2018

Where Things Stood

Understanding the impact of what we have seen so far this year first requires an understanding of where we were at the end of 2017, with respect to both Medicare reimbursement and provider adoption of telehealth solutions.

Hospitals and health systems have long understood that digital health technologies allow patients to be active participants in their health while also allowing health care providers to intervene before costs and complications escalate. At the close of 2017, direct-to-consumer telehealth companies had matured and were working closely with commercial payors to deliver telehealth services to plan beneficiaries….

2019 Medicare Physician Fee Schedule and Quality Payment Program – CMS Proposed Rule CPT Codes 990X0, 990X1, and 994X9

CMS’ explanation for its bold, new proposal: “We now recognize that advances in communication technology have changed patients’ and practitioners’ expectations regarding the quantity and quality of information that can be conveyed via communication technology. From the ubiquity of synchronous, audio/video applications to the increased use of patient-facing health portals, a broader range of services can be furnished by health care professionals via communication technology as compared to 20 years ago.”

The biggest takeaways from the proposed…

CMS Makes a ‘Landmark Change’ in RPM, Telehealth Reimbursement

Digital health expert Nathaniel Lacktman breaks down CMS’ proposed 2019 Physician Fee Schedule and Quality Payment Program, examining how it should boost support for services like remote patient management and store-and-forward telehealth.

By Eric Wicklund

– Earlier this month, the Centers for Medicare & Medicaid Services unveiled its proposed 2019 Medicare Physician Fee Schedule and Quality Payment Program, with several amendments designed to boost remote patient monitoring and telehealth programs through improved reimbursements.

Reaction so far – public comments are due back to CMS by September 10 and a final ruling is expected in…

CMS physician payment proposal nudges open the door for telehealth

CMS estimated that reimbursing for virtual check-ins would reach an estimated 19 million visits per year.

Virtual care reimbursement proposed by Medicare: 5 things to know

CMS made a series of suggestions to expand telehealth in its latest Medicare Physician Fee Schedule and Quality Payment Program, a 1,473-page proposal released July 12.

Here are five telehealth changes CMS proposed:

1. Although CMS has bundled “routine non-face-to-face communication” into the cost of in-person visits, the agency is proposing to reimburse physicians for video or audio check-ins even if they don’t result in an office visit.

2. Medicare would pay $14 per virtual check-in, compared to the cost of…

Telehealth Advocates Respond to CMS ‘Virtual Visit’ Proposal

July 16, 2018
by David Raths
To get around legal restrictions on telehealth reimbursement, CMS expands its definition of ‘communication technology–based services’

Among all the proposed changes the Centers for Medicare and Medicaid Services (CMS) rolled out last week, ones related to telehealth drew considerable interest. Although it can’t use its regulatory power to change the laws that restrict telehealth services paid for by Medicare to rural settings, the agency has instead defined new “communication technology–based services”…

Healthcare Leaders React to CMS’ 2019 QPP Proposed Rule and E&M Coding Changes

Many health IT industry groups, policy experts and other industry stakeholders continue to delve into the 1,473-page proposed rule released by the Centers for Medicare and Medicaid Services (CMS) on July 12 that provides updates to the Physician Fee Schedule and Quality Payment Program (QPP), which encapsulates the Medicare Incentive-based Payment Program (MIPS) and Advanced Payment Models.

When CMS announced the proposed rule last week for CY 2019, the agency said the changes will “fundamentally improve the nation’s healthcare system and help restore the doctor-patient relationship by empowering clinicians to…

Federal Regulatory Developments Brewing in Telehealth

Two federal agencies – the Centers for Medicare and Medicaid Services (“CMS”) and the Federal Communications Commission (“FCC”) – announced separate initiatives last week that stand to increase patient access to telehealth services.

Proposed Medicare Physician Fee Schedule for Calendar Year 2019. The CY 2019 Medicare Physician Fee Schedule Proposed Rule (the “Proposed Rule”) was released for publication in the Federal Register on July 12, 2018. The Proposed Rule updates payment policies, payment rates, and other provisions for Medicare-covered…

Remote Patient Monitoring Redefining mHealth Care Management

With the development of the “smart home” concept, the Internet of Things (IoT) and better mHealth technology, remote patient monitoring (RPM) has the potential to bring care management and coordination into the home and make health and wellness an integral part of life. The potential use cases for RPM in mHealth care management include chronic care management, post-discharge care, senior care, workmen’s compensation cases, and behavioral health and substance abuse cases.

Most of these programs focus on the collection of patient health data from home (by self or automatically) through devices and mobile health platforms that connect to the primary…

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