MedPAC Discusses Post-COVID Telehealth

Should Medicare continue to encourage the use of telehealth when the COVID-19 pandemic ends?

Should it continue to pay for telehealth when the there is no “tele” in the service and it is audio only?

And should Medicare pay different rates for visits in person, telehealth visits, and audio-only (that is, telephone) visits?

These were among the questions addressed by members of the Medicare Payment Advisory Commission during their public meetings last week.

Members also discussed the need for further analysis of the effectiveness of telehealth and audio-only visits, how to identify audio-only visits on Medicare claims, how to collect data from home health agencies and hospices, which are not required to submit telehealth data, and more.

Learn more about what MedPAC is thinking about the use of telehealth in the future in the MedPage Today article “Medicare Advisors Consider Post-Pandemic Telehealth Pay Policy.”

MedPAC: Go Slow on Expanding Medicare Telehealth

MedPAC wants Medicare to test the impact of telehealth on health care under non-COVID-19 conditions before moving forward with expanding the tool’s use in the Medicare population.

In a news release accompanying its recently released annual report to Congress on Medicare payment policy, the Medicare Payment Advisory Commission writes that

In the report, we present a policy option for expanded coverage for Medicare telehealth policy after the PHE is over. Under the policy option, policymakers should temporarily continue some of the telehealth expansions for a limited duration of time (e.g., one to two years after the PHE) to gather more evidence about the impact of telehealth on beneficiary access to care, quality of care, and program spending to inform any permanent changes. During this limited period, Medicare should temporarily pay for specified telehealth services provided to all beneficiaries regardless of their location, and it should continue to cover certain newly-covered telehealth services and certain audio-only telehealth services if there is potential for clinical benefit.

The policy option also specifies that after the PHE ends, Medicare should return to paying the physician fee schedule’s facility rate for telehealth services and collect data on the cost of providing those services. In addition, providers should not be allowed to reduce or waive beneficiary cost sharing for telehealth services after the PHE. CMS should also implement other safeguards to protect the Medicare program and its beneficiaries from unnecessary spending and potential fraud related to telehealth.

While MedPAC’s recommendations to Congress are not binding on the administration, its work is highly respected and it is considered influential in the development of Medicare reimbursement policy.

Learn more about what MedPAC has to say about telehealth services and other aspects of Medicare payment policy in this MedPAC news release and the MedPAC’s newly released Report to the Congress:  Medicare Payment Policy.


MedPAC Talks Telehealth

Expanded telehealth is here to stay, members of the Medicare Payment Advisory Commission agreed at their September public meeting.

What they do not yet know is in what form.

Among the issues that need to be addressed in any post-COVID-19 expansion of Medicare-covered telehealth services are:

  • Whether affording access to telehealth services would exacerbate the digital divide and leave some Medicare beneficiaries with less access to care than others.
  • Whether audio-only coverage, temporarily permitted during the pandemic, should be continued.
  • Whether greater use of telehealth might foster greater use of low-value services.
  • Whether use of non-HIPAA-compliant video technology should continue to be permitted.

Learn more about MedPAC’s deliberations on telehealth in the Healthcare Dive article “MedPAC commissioners hint at telehealth policies that may stick post-COVID-19” and see the presentation that formed the basis for the discussion of this issue at MedPAC’s recent public meeting.