Reimbursement

Medicare: More Telehealth for Medicare Advantage

October 29, 2018


Medicare’s efforts to make telehealth services more widely available to beneficiaries continues. The Centers for Medicare & Medicaid Services (CMS) recently proposed to significantly expand the telehealth benefits available via its Medicare Advantage (MA) program, which allows beneficiaries to receive their Medicare benefits through private health plans. Some 19 million Medicare beneficiaries are enrolled in MA plans versus 38 million in traditional Medicare.
The proposed rule would, starting in 2020, allow MA plans to provide new telehealth benefits as part of their basic benefits package, beyond what is currently allowable under traditional Medicare. Also:
 

  • Plans could offer greater flexibility in telehealth benefits to all enrollees, whether they live in rural or urban areas.
  • Enrollees could receive telehealth from a variety of locations, including their homes, not just health care facilities.
  • Plans could also offer clinically-appropriate telehealth benefits not otherwise available to Medicare beneficiaries.
  • Telehealth benefits can include remote access technologies and telemonitoring.
     

Current rules in the traditional Medicare program generally limit telehealth to rural areas and require that services be provided only in specific kinds of health care facilities.  

Comments are due on the proposal by December 31, 2018.
 

View CMS press release.

View CMS fact sheet.