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CMS Proposes New Rule to Expand Telehealth Benefits Under Medicare Advantage Plans

Posted in Hospitals and Institutions, Medicare and Medicaid, Private Insurers, Reimbursement Matters

The Centers for Medicare & Medicaid Services (CMS) has proposed a new rule that, effective plan year 2020, would allow Medicare Advantage (“MA”) insurers to be reimbursed for additional telehealth services not otherwise available through traditional fee-for-service Medicare. This change will provide MA plans with more flexibility to include telehealth services for enrollees in their home, rather than being on-site at a health care facility. CMS published a fact sheet describing the proposal. “CMS believes that the additional telehealth benefits in MA will increase access to patient-centered care by giving enrollees more control to determine when, where, and how they access benefits.”

MA plans are popular among Medicare enrollees, and CMS continues to promote MA plans. About thirty percent of all Medicare beneficiaries are currently enrolled in a MA plan, and that number continues to grow. CMS projects that MA enrollment will increase by 11.5% in plan year 2019, with 600 new plans available nationwide.

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