CMS final rules for Medicare Advantage plans and telehealth – 2019
The Center for Medicare and Medicaid Services (CMS) released their final rules for changes to Medicare Advantage (MA) plans and how they may treat telehealth-delivered services in basic coverage plans. The 2018 Bipartisan Budget Act (BBA) allowed MA plans to begin covering telehealth-delivered services beyond what was statutorily required in Original Medicare (also known as Medicare Fee-For-Service) without offering these services under a supplemental plan. Currently, MA plans are required to cover the same telehealth-delivered services that are reimbursed in Original Medicare with the same limitations (patient must be in a rural area, only certain services are reimbursed, etc.). If MA plans wished to offer telehealth-delivered services that were not eligible under Original Medicare, they would have to be covered under a supplemental plan. The BBA stated that starting in 2020, MA plans would be allowed to offer telehealth as a mode of delivering any service already covered under Medicare Part B and not be subject to the limitations Original Medicare imposes. MA plans will be able to include the provision of these services within their calculations on basic benefit bids. The final rules issued by CMS clarified what would be allowed and other features on how MA plans can adopt these changes into their policies.
MA Plan CMS Final Rules 2019