CMS proposes new rule to expand telehealth coverage to MA beneficiaries


CMS has proposed a new rule from that would expand Medicare Advantage (MA) and Part D telehealth benefits in 2020. The changes will likely make telehealth services more accessible to Medicare beneficiaries at home.

MA plans, which are CMS-contracted private insurers, currently cover about one-third of all Medicare beneficiaries and are expected to continue growing.

Next year, MA enrollment is projected to grow 11.5 percent with premiums declining at 6.1 percent, according to CMS. Approximately 600 more plans will also be available across the nation. The proposal leverages the Bipartisan Budget Act of 2018, which gave MA plans more telehealth benefits.

“Today’s proposed changes would give Medicare Advantage plans more flexibility to innovate in response to patients’ needs,” CMS Administrator Seema Verma said in a statement. “I am especially excited about proposed changes to allow additional telehealth benefits, which will promote access to care in a more convenient and cost-effective manner for patients.”

The proposal would provide MA plans with more flexibility with respect to how they pay for telehealth. At the moment, traditional Medicare allows telehealth services for rural beneficiaries, but has limitations. And with the new rule, MA plans could also provide telehealth benefits to enrollees in their homes, whether in urban or rural areas.

“While MA plans have always been able to offer more telehealth services than are currently payable under original Medicare through supplemental benefits, this change in how such additional telehealth benefits are financed (that is, accounted for in payments to plans) makes it more likely that MA plans will offer them and that more enrollees will be able to use the benefits,” CMS stated about the proposal.