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Advisory Commission Calls for Temporary Continuation of Expanded Medicare Telehealth Coverage
March 30, 2021

The Medicare Payment Advisory Commission (MedPAC) published recommendations to Congress on March 15th to continue some Medicare COVID-19 telehealth coverage expansions only temporarily to allow more time for study before making any policies permanent. Devoting the final chapter of its report to telehealth, MedPAC advises that Medicare continue for a “limited duration (e.g. one to two years)” covering telehealth services regardless of patient location, including beneficiaries at home, as well as the over 140 telehealth services that were temporarily added to the Physician Fee Schedule, such as emergency department visits. MedPAC also recommends maintaining the allowance of audio-only interactions based on clinical assessment and potential for clinical benefit, for instance audio-only evaluation and management visits with established patients.

Social Determinants of Health Stymied Pandemic Telehealth Use
March 25, 2021

Telehealth compensated for much of the care delivery gap brought on by COVID-19, however social determinants of health effected utilization rates significantly, according to a study published in JAMA Network Open that raises concern for care access disparities.

From March to June of 2019, telehealth claims made up less than 0.3 percent of total outpatient consults. One year and a pandemic later, telehealth claims made up a quarter (24 percent) of privately insured outpatient consults, based on claims data for more than 36.6 million working-age, privately insured members who were continuously enrolled from March through June of 2020.

Overall, the researchers found that outpatient visits in brick-and-mortar locations decreased by 37 percent, with 1.63 visits per enrollee in 2019 and 1.02 visits per enrollee in 2020.

CCHP Releases Updated Telehealth Billing Guide
March 16, 2021

The Center for Connected Health Policy (CCHP) has released a new updated telehealth billing guide as a follow up to its 2020 billing guide to provide a helpful tool for healthcare entities trying to navigate the complexities of billing for telehealth and virtually delivered services.  Policy changes during the COVID-19 Public Health Emergency (PHE) have only made telehealth billing rules more nuanced.  The updated billing guide addresses whether or not there is reimbursement for telehealth both generally and/or during the PHE, as well as how to correctly bill for a telehealth encounter, which is one of the most common policy questions CCHP receives as the National Telehealth Policy Resource Center (NTRC – P). Further complicating the billing process is the need to understand whether current rules are only applicable during the pandemic as well as the fact that payer policies continue to vary from payer to payer.  For example, policies that apply to a Medicare beneficiary remain different than those that apply to a state Medicaid enrollee or to patients that have private insurance.

Credentialing by Proxy: Joint Commission’s Improved Telemedicine Accreditation Rules
March 15, 2021

The Joint Commission recently announced it has changed its accreditation rules to enable more hospitals and telemedicine companies to use the streamlined “credentialing by proxy” process. Under the change, the distant site telemedicine entity must be accredited with The Joint Commission or enrolled in the Medicare program. Previously, the rules required both the originating site hospital and the distant site entity to be accredited with The Joint Commission. That requirement of dual-accreditation was exclusively created by The Joint Commission, and was not mandated by the CMS Medicare regulations.

Behavioral Health Workforce Development Technical Assistance and Evaluation - Funding Opportunity
March 2, 2021

Eligible applicants for the BHWD TAE are: Health professions schools, academic health centers, State or local governments, or other public or private nonprofit entities that provide services and training to health professions. A nationally recognized accrediting body, as specified by the U.S. Department of Education, must accredit applicants that are institutions of higher education. These applicants must submit their accreditation documentation as Attachment 4. Accredited health professions schools and academic health centers applicants are required to submit accreditation documentation. Those that fail to attach a copy of the required accreditation documentation as Attachment 4 will be considered non-responsive and will not be considered for funding under this announcement. Applicants are required to maintain their accreditation throughout the project period and notify HRSA of any change in status. Eligible entities must be located in the 50 states, the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, America Samoa, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, or the Republic of Palau. Domestic faith-based and community-based organizations, tribes, and tribal organizations are eligible to apply, if otherwise eligible.

Utah Expands Telehealth Coverage for Mental Health Services
March 9, 2021

Utah's governor has signed into a law a bill that establishes Medicaid and commercial payer coverage for healthcare providers using telehealth to deliver mental healthcare services.