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MedPAC Recommends Expanding Telehealth Services in Medicare

March 19, 2021

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CONTACTS
Ki Stewart, Policy and Regulatory Analyst

The Medicare Payment Advisory Commission (MedPAC) released a report to Congress on March 16 that includes a policy option for expanding telehealth in Medicare after the public health emergency [see related story].

In this report, MedPAC recommended that policymakers should continue some aspects of the recent telehealth expansion temporarily (e.g., one to two years) after the public health emergency ends, both to collect more data on the expansion’s impact on access, quality, and cost and to use that data to create a permanent policy. These include continuing to pay for specified telehealth services without considering location and covering selected telehealth services and audio-only services “with possible clinical benefit”.

When the public health emergency ends, MedPAC recommended that “Medicare should return to paying the fee schedule’s facility rate for telehealth services and collect data on the cost of providing these services.” It also states that providers should no longer be permitted to “reduce or waive cost sharing for telehealth services.”

Finally, MedPAC’s policy recommended that the Centers for Medicare and Medicaid Services permanently establish three safeguards after the public health emergency ends to prevent “unnecessary spending and potential fraud related to telehealth.” These include applying additional scrutiny to outlier clinicians who bill significantly more telehealth per capita, requiring in-person visits before clinicians order expensive medical equipment or laboratory tests, and prohibiting ‘incident to’ billing for telehealth services by clinicians who can bill Medicare directly.

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