April 16, 2020

Megan Herber Comments on CMS Expansion of Telehealth Accessibility

In a recent memo, the Centers for Medicare and Medicaid Services expressed an urgency to expand the use of virtual care to reduce the risk of spreading COVID-19 and announced new latitude for plans to apply diagnoses from telehealth visits for risk adjustment purposes.

Director Megan Herber commented on this expansion with RADAR on Medicare Advantage, acknowledging past interest from Congress and providers in increased telehealth adoption.

The memo, she remarks, is good news for plans and is “pretty permissive” in that it doesn’t limit diagnoses used for risk adjustment to specific types of telehealth (e.g., primary care vs. specialty). “But they don’t explicitly say it’s only temporary during the pandemic,” she points out. “Either way, we want it to be permanent, so we’ll keep working on that. And if they don’t put anything [additional] out, maybe they’ll see that it works and keep it going.”

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