Expansion of Telemedicine by Medicare Advantage: Huge Step Forward

April 9th, 2019

CMS has taken huge step forward toward coverage of telemedicine and virtual care.  In their recently published ruling, CMS has agreed to expand the geographic coverage of telemedicine services, as well as the scope of services covered.

“Under this final rule, MA enrollees may have great opportunities to receive healthcare services from places like their homes, rather than being required to go to a healthcare facility,” according to a CMS press release. “MA plans will now have broader flexibility than is currently available in how they pay for coverage of telehealth benefits to meet the needs of their enrollees.”

This, in addition to the Chronic Care Act passed by the Senate in 2017, greatly expand the scope of coverage of telemedicine in areas and modalities not previously compensated in prior systems.

On the ground, telemedicine companies, patients and providers are still waiting for the grand reimbursement that CMS rules have promoted.  The intuitive integration of telemedicine services into standard practice, the routine and simple reimbursement of clinical services, have yet to be instituted into mainstream medicine.  We are all awaiting that time when those real pragmatic changes are instituted.