In a June 25 notice, the Centers for Medicare & Medicaid Services unveiled a proposed rule to make permanent emergency rules enacted on March 30 to address the coronavirus pandemic. The proposed rule will be published in the Federal Register on June 30.
In response to the COVID-19 crisis, CMS enabled home healthcare providers to use connected health platforms to provide more services as long as those services are part of the patient’s care plan and they don’t replace needed in-person visits as ordered in the original care plan.
That order also enabled physicians to qualify patients for the Medicare Home Health Benefit if they determine that the patient can’t leave home to access care because of a “medical contraindication or due to suspected or confirmed COVID-19.”
Home health advocates note that this proposal won’t reimburse them for telehealth services, for which the National Association of Home Care & Hospice is currently lobbying. But it does give them the leeway to use more telemedicine and mHealth technology to deliver care.
“The use of technology may not substitute for an in-person home visit that is ordered on the plan of care and cannot be considered a visit for the purpose of patient eligibility or payment; however, the use of technology may result in changes to the frequencies and types of in-person visits as ordered on the plan of care,” the CMS notice states. “This rule also proposes to allow HHAs to continue to report the costs of telecommunications technology as allowable administrative costs on the home health agency cost report beyond the PHE for the COVID-19 pandemic.”
“These proposed changes are one of the first flexibilities provided during the COVID-19 PHE that CMS is proposing to make a permanent part of the Medicare program,” the notice continues. “These proposals would ensure patient access to the latest technology and give home health agencies predictability that they can continue to use telecommunications technology as part of patient care beyond the PHE.”
CMS officials have reportedly been receptive to extending more telehealth freedoms beyond the current state of emergency, and NAHC officials have said they’re thinking about expanding telehealth coverage for home healthcare.
In a panel session during Thursday’s American Telemedicine Association virtual conference, Emily Yoder, an analyst in CMS’ Division of Practitioner Services, said Congress has the authority to make policy changes (and lawmakers are under increasing pressure to make those changes), while CMS must focus on regulatory changes.
Yoder said CMS expects to file proposed regulatory changes for Medicare coverage of telehealth in mid-July in the Federal Register, and urged telehealth providers and advocates to be ready to comment on the proposals.
Along with telehealth provisions announced this week, CMS has proposed increasing Medicare payments to home health agencies by 2.6 percent, adding roughly $540 million to the coffers. This doubles the increase proposed last year for the 2020 year.