Access to Medicare telehealth is maintained in the doctor’s pay rule

CMS wants to make it easier for Medicare beneficiaries to use telehealth services, improve its diabetes prevention program and review its Quality Payment Program, according to the proposed 2022 physician tariff program released Tuesday. .

During the COVID-19 pandemic, CMS temporarily allowed Medicare providers to transmit a wide range of health services via telecare until the end of the public health emergency. Now, many patients, providers and legislators want to make these changes permanent. But some experts worry that CMS will not have enough information about how these expanded telecare services affect the Medicare program and its beneficiaries in terms of health care use and quality.

As a result, CMS plans to allow Medicare providers to offer certain services via telehealth until the end of 2023 to alleviate concerns on both sides. The idea is to create a glide path for consumers and suppliers while the agency decides whether to add these services to the telehealth list permanently.

“Over the past year, the public health emergency has highlighted disparities in the U.S. health care system, while demonstrating at the same time the positive impact of innovative policies to reduce these disparities,” he said. CMS administrator Chiquita Brooks-LaSure in a press release. “CMS aims to take the lessons learned during this time and move towards a system where no patients are left out, and everyone has access to complete quality health services.”

In addition, CMS will allow all Medicare patients to access telehealth services from their homes, as called for in the Congressional spending package last December. The agency also wants to allow Medicare to pay for mental health visits through telecare services provided by community health centers.

“The COVID-19 pandemic has put a lot of effort on families and individuals, making access to behavioral health services more crucial than ever,” Brooks-LaSure said.

To improve access to care, CMS plans to allow providers to provide only audio behavioral and mental health services, including treatment of opioid dependence.

CMS hopes to get more people to participate in its highly malignant Medicare Diabetes Prevention Program by permanently waiving the Medicare enrollment fee for new organizations, shortening the service period from two years to one and increasing payments to successful organizations. CMS believes the changes will facilitate access to the program for people in underserved communities.

In addition, CMS proposes key changes to the Quality Payment Program, including the Merit-Based Incentive Payment System. The agency wants to make it more difficult for clinicians to earn bonuses by virtue of its Quality Payment Program by increasing the eligibility threshold. CMS also unveiled its first seven MIPS Value Pathways, including rheumatology, stroke care and prevention, heart disease, chronic disease management, emergency medicine, anesthesia and lower extremity joint repair, as well. and knee replacements.

As part of these initiatives, CMS would evaluate clinicians using measures that are significant to their practices and specialties or are relevant to public health priorities.

The regulation proposes several policy changes that recognize the growing role of providers of advanced practices in the health care system. In a notable change, medical assistants could bill Medicare directly for outpatient services, instead of filing claims through their full-time employers or contracts.

The conversion factor proposed by the agency for 2022 is $ 33.58, $ 1.31 menu than for this year, and marks the end of the payment expenditure of 3.75% by the December expenditure legislation.

Other modified policies include new drug price reporting requirements for drugs that do not participate in the Drug Discount Medicaid Program and many tweaks to the Medicare Shared Savings program, including changes that make it easier for providers to take more risk of disadvantage and to report quality data. CMS also plans to eliminate co-insurance for diagnostic tests resulting from planned collection screenings.

The Biden administration is seeking feedback on several vaccine reimbursement proposals and how CMS can advance health equity through improved data collection. The comments were posted September 13th.

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