A proposal by the Centers for Medicare & Medicaid Services (CMS) would increase access to telemedicine services for seniors with Medicare Advantage health plans.
Under the proposal, Medicare Advantage plans would cover, beginning in 2020, telemedicine services that are not traditionally covered by fee-for-service Medicare.
Plan members would be covered even if they receive telehealth services at home.
The proposal complements Pennsylvania’s Senate Bill 780. The bill – which was sponsored Sen. Elder Vogel (R-Beaver) – defines telemedicine, provided consumer protections and expands insurance reimbursement for telemedicine services.
Rep. Marguerite Quinn (R-Bucks) introduced a companion bill in the House.
The bill advanced through the Senate and the House Professional Licensure Committee but was not voted on in the House before the end of the 2017–2018 legislative session.
The bill has the support of the state’s health care advocates.
In addition, CMS’ proposal would make it easier for Medicare and Medicaid enrollees in certain dual-eligible special-needs plans to file appeals, would require health plans to integrate benefits across Medicare and Medicaid seamlessly, would update the methodology for calculating Medicare Advantage plan star ratings and would recoup over a 10-year period $4.5 billion in overpayments to Medicare Advantage plans from improper payments.
CMS is accepting comments on the proposal until Dec. 31.