Skip to main content
Sister Publication Links
  • ESG: THE NEW IMPERATIVE
Subscribe
  • My Account
  • Login
  • Subscribe
  • News
    • Current News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Digital Health
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
  • Data/Lists
    • Rankings/Lists
    • Interactive Databases
    • Data Points
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Awards
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
    • Women in Healthcare
    • - Luminaries
    • - Top 25 Diversity Leaders
    • - Leaders to Watch
    • - Luminaries
    • - Top 25 Women Leaders
    • - Women to Watch
  • Events
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Transformation Summit
    • Women Leaders in Healthcare Conference
    • Social Determinants of Health Symposium
    • Leadership Symposium
    • Health Care Hall of Fame Gala
    • Top 25 Women Leaders Gala
    • Best Places to Work Awards Gala
    • Top 25 Diversity Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Supply Chain Revenue Cycle
    • - Hospital at Home
    • - Workplace of the Future
    • - Strategic Marketing
    • - Virtual Health
  • Listen
    • Podcast - Next Up
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Transformation Hub

Where healthcare challenges find solutions

  • Patients
  • Operations
  • Care Delivery
  • Payment
Payment
June 02, 2020 04:52 PM

Providers want more telehealth flexibility and higher CMS payments

Michael Brady
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    Modern Healthcare Illustration / Getty Images

    Rather than stopping telehealth's momentum when the COVID-19 pandemic ends, provider groups want CMS to press forward by allowing more providers to take part in virtual care and boosting reimbursements for telehealth services.

    In their comments on CMS' emergency changes to the Medicare program, provider groups praised the agency for its unprecedented extension of telehealth benefits during the COVID-19 pandemic. But they argued that the federal government should make permanent changes following the tectonic shift in telehealth during the past few months.

    "It is imperative that the progress that has been made since March continue when the (public health emergency) ends," the Association of American Medical Colleges said.

    AAMC asked the agency to extend the telehealth flexibilities and waivers for one year beyond the end of the public health emergency to give Congress and federal regulators time to act. Public officials across the board support the long-term expansion of telehealth services, so it's likely a matter of when, not if the changes will be made permanent.

    Hospitals, medical groups and clinicians also want CMS to allow more providers to deliver higher levels of telehealth services to beneficiaries. For instance, there has been an increase in the number of inpatient interprofessional consultations during the COVID-19 pandemic, but CMS limits how often they can occur. Hospitals want the agency to lift the restrictions so that they can respond quickly to the healthcare needs COVID-19 patients without putting other patients, or their finances, at-risk.

    Likewise, CMS has said that telehealth visits cannot replace in-person or home health visits under Medicare's home health benefit, a restriction that's made it more difficult for providers to deliver care to worried seniors.

    "We have heard of instances where patients are refusing in-home care out of fear of contracting COVID-19. In these instances, telehealth may be the only possible avenue to access the patient and provide them with the healthcare they require," the American Association of Nurse Practitioners said.

    Pharmacists are asking CMS for additional flexibilities and more forgiving enforcement discretion to allow them to assist with COVID-19 testing and other services, including clarifications about what services they can deliver and bill Medicare for, given the vague language included in CMS' interim final rule.

    There "remains a number of logistical, pharmacist and pharmacy payment, and patient access issues that must be addressed in order to fully implement the pharmacist testing guidance and create a pathway for all pharmacies and pharmacists to offer COVID-19 point of care testing for all patients," the American Pharmacists Association said.

    Provider groups are asking for increased reimbursement for telephone-only telehealth services too. CMS temporarily approved payment for telephone-only evaluation and management, or E/M, services in March. But providers say the reimbursements are too low because they don't reflect the level of services that clinicians are delivering during the pandemic. Some patients are unwilling or unable to use video-based telehealth services, especially beneficiaries that are older and poorer.

    "In many instances, the way our members are providing care to their patients by telephone is far more akin to a standard, face-to-face E/M visit, or a visit when it is conducted using real-time audiovisual technology," the American Academy of Physical Medicine and Rehabilitation said.

    The National Association of ACOs and eight other groups representing providers in accountable care organizations asked CMS to take several actions in response to the COVID-19 pandemic. They want the agency to give ACOs the option to give up some of their shared savings in exchange for protection against financial losses and extend the deadline for the Medicare Shared Saving Program. ACO providers also want CMS to overturn its decision to cancel the 2021 MSSP application cycle and to make ACO shared savings and Advanced APM bonus payments as soon as possible, according to a joint letter.

    In addition, ambulatory surgical centers suggested that CMS' new Hospital Without Walls policy may not give them enough flexibility to enroll in Medicare as a hospital during a public health emergency, citing evidence that only a dozen or so ambulatory surgical centers and freestanding emergency departments had applied as of April 30.

    "In the event of another wave of the virus, we encourage CMS to consider additional flexibilities, in consultation with the ASC community, that would allow ASCs to provide surge capacity," said the Alliance for Orthopedic Solutions.

    Tags: Payment, This Week in Healthcare, Coronavirus, Regulation, Payment, Payment reform, Telehealth, Accountable Care Organizations, Policy, Transformation, Transformation Hub
    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    hospital-money_costs_i_i.png
    Employer health plans pay hospitals 224% of Medicare
    corona-hospital-money-mask_i.png
    5 ways COVID-19 shows up in CMS' proposed hospital pay rule
    Sponsored Content
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2022. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Digital Health
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Data/Lists
      • Rankings/Lists
      • Interactive Databases
      • Data Points
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Nominate/Eligibility
      • 100 Most Influential People
      • 50 Most Influential Clinical Executives
      • Best Places to Work in Healthcare
      • Excellence in Governance
      • Health Care Hall of Fame
      • Healthcare Marketing Impact Awards
      • Top 25 Emerging Leaders
      • Top 25 Innovators
      • Diversity in Healthcare
        • - Luminaries
        • - Top 25 Diversity Leaders
        • - Leaders to Watch
      • Women in Healthcare
        • - Luminaries
        • - Top 25 Women Leaders
        • - Women to Watch
    • Events
      • Conferences
        • Transformation Summit
        • Women Leaders in Healthcare Conference
        • Social Determinants of Health Symposium
        • Leadership Symposium
      • Galas
        • Health Care Hall of Fame Gala
        • Top 25 Women Leaders Gala
        • Best Places to Work Awards Gala
        • Top 25 Diversity Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Supply Chain Revenue Cycle
        • - Hospital at Home
        • - Workplace of the Future
        • - Strategic Marketing
        • - Virtual Health
      • Webinars
    • Listen
      • Podcast - Next Up
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing