CMS expands telehealth for Medicare Advantage plans: 4 details

CMS finalized a rule to encourage Medicare Advantage plans to increase telehealth benefits and plan options for beneficiaries in rural areas.

The rule gives the plans flexibility to count telehealth providers in some specialty areas, including dermatology, psychiatry, cardiology, ophthalmology, nephrology, primary care, gynecology, endocrinology and infectious disease, toward meeting CMS network adequacy standards.

"CMS's rapid changes to telehealth are a godsend to patients and providers and allows people to be treated in the safety of their home," said CMS Administrator Seema Verma."The changes we are making will help make telehealth more widely available in Medicare Advantage and are part of larger efforts to advance telehealth."

The agency also reduced the percentage of beneficiaries that must reside within the maximum time and distance standards in nonurban counties from 90 percent to 85 percent for Medicare Advantage plans to comply with the network adequacy standards for contracted telehealth providers.

CMS also gave beneficiaries with end-stage renal disease more coverage options under the Medicare program with the new rule. Beneficiaries with ESRD previously were only able to enroll in Medicare Advantage plans in limited circumstances, but the new rule will give all beneficiaries with ESRD the ability to enroll in Medicare Advantage plans next year.

The agency said it is also finalizing proposals to improve the Medicare Advantage and Part D Star Rating System to increase the focus on patient experience and access to care measures on the plan's overall star rating.

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