Services delivered by telehealth and in person will be equal in the eyes of Medicare Advantage (MA), according to the final CMS regulation for the 2020 plan year, which was announced April 5. If the MA plans embrace telehealth, their Part B services must be covered the same, whether they’re delivered in person or by “electronic exchange.” And far more MA enrollees will be eligible for telehealth services because there are no geographical restrictions, which limit telehealth in original Medicare. Enrollees may have telehealth visits in urban, suburban and rural areas, and can be treated from home.
“It’s now a part of the core package” of Medicare Advantage, says attorney Sidney Welch, with Akerman in Atlanta, Georgia.
The final regulation says MA plans are permitted to offer “additional telehealth benefits” as part of the basic benefit package, beyond what’s now allowed under original (fee-for-service) Medicare. “In addition, MA plans will continue to be able to offer MA supplemental benefits (that is, benefits not covered by original Medicare) via remote access technologies and/or telemonitoring (referred to as ‘MA supplemental telehealth benefits’ in this rule) for those services that do not meet the requirements for coverage under original Medicare or the requirements for MA additional telehealth benefits,” according to the regulation, which interprets provisions from the Bipartisan Budget Act of 2018. CMS tweaked the proposed rule but mostly left it intact (“CMS Proposed Rule Expands MA Telehealth Coverage to All Part B Services, All Regions,” RMC 27, no. 39).