AMGA supports effort to expand telehealth services to Medicare Advantage

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The American Medical Group Association strongly supports a proposed rule to broaden the spectrum of telehealth services offered to Medicare Advantage enrollees.

In October, the Centers for Medicare and Medicaid Services issued a proposal to expand telehealth benefits within the MA program—starting in 2020—beyond what is currently available to those beneficiaries in fee-for-service Medicare.

Also See: Medicare to expand beneficiary access to telehealth services

AMGA, representing more than 175,000 physicians who deliver care to one in three Americans, applauds the CMS initiative to remove restrictions that prevent Medicare providers from leveraging telehealth services to improve outcomes for beneficiaries.

“As we advance patient-centric care, telehealth is an important tool that should be as broadly available to providers as possible,” said Jerry Penso, MD, AMGA’s president and CEO. “Physicians are in the best position to determine how to meet their patients’ needs and CMS’ proposal creates a framework that will encourage MA plans to work with the provider community to develop coverage policies that encourage the appropriate use of telehealth.”

On Monday, AMGA, which represents more than 450 multispecialty medical groups and integrated delivery systems, sent written comments to CMS with three specific recommendations regarding the agency’s proposed rule.

  • CMS should finalize its proposal not to impose any restrictions on the types of Part B items and services that MA plans may offer as an additional telehealth benefit.
  • The agency should include in its requirement that any services offered as a telehealth benefit also be covered for in-person visits.
  • CMS should finalize its proposal to require MA plans to cover additional telehealth benefits through contracted providers.

“AMGA is pleased that CMS is proposing to broadly interpret the type of services that MA plans may offer under this expanded benefit,” states the medical group association in their letter to the agency.

The CMS proposed rule implements provisions of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act, which AMGA endorsed and was enacted into law as part of the Bipartisan Budget Act of 2018.

“Historically, telehealth has faced some restrictions on its availability. We strongly supported the effort in Congress to expand how providers and patients can benefit from telehealth and believe CMS’ proposal is a welcome addition to the MA program,” added Penso.

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