An Ounce of Prevention
Whether your practice is already delivering or is planning to deliver RPM services to Medicare and/or Medicaid patients this year, you must understand the CMS rules for remote patient monitoring services in 2020. Without this knowledge, you run the risk of not getting paid appropriately for remote patient monitoring by CMS (Centers for Medicare & Medicaid Services) and possibly running afoul of requirements that can jeopardize your reimbursement and lead to regulatory headaches. To help ensure you receive appropriate and timely payments for remote patient monitoring from CMS and avoid legal scrutiny for RPM services, here are three key things to know.
The story below provides a brief overview of this breaking news. If you are interested in a more in-depth discussion and analysis, you can watch a recent webinar we hosted on the topic here. The Centers for Medicare & Medicaid Services (CMS) has released its 2021 Medicare physician fee schedule proposed rule, which includes many proposed changes to remote patient monitoring (RPM).
Healthcare providers have found themselves under immense pressure to maintain continuity of care during the COVID-19 crisis, but many aspects of the U.S. health system were not designed to support such an effort. To help providers more effectively deliver care that will not only keep patients healthy but also in their homes and away from hospitals, which are largely focused on treating COVID-19 patients, government agencies, commercial payers, and other healthcare organizations have worked to change the system. Approaches taken include the creation of new and expansion of existing telehealth and remote tools and support, including remote patient monitoring (RPM). For example, we have seen federal waivers and revised state regulations that greatly expand the ability for healthcare providers to deliver telehealth and remote services; commercial payers revising their policies to pay for these services, and healthcare companies offering resources to help providers more effectively leverage telehealth and remote services during the crisis. If your practice is considering launching or growing an existing telehealth and/or remote services program during the pandemic, here are five things you should know.
The annual wellness visit (AWV) is an important tool for providers to track and help manage the health and wellbeing of their Medicare patients. Social distancing is crucial to combat our current health crisis, but so is maintaining continuity of care with your most vulnerable patients. Fortunately, Medicare understands the importance of the AWV, and included it in it's initial §1135 waiver so that it can be performed entirely via telehealth on any Medicare beneficiary. As of 4/30/20, Medicare further waived restrictions, and now allows Annual Wellness Visits to be conducted via audio-only telehealth (i.e. over the telephone) for the duration of the waiver.
Updated: 10/13/2020: US Health and Human Services have extended the health emergency to January 21, 2020. The Centers for Medicare & Medicaid Services (CMS) has announced a significant, temporary broadening of telehealth services coverage.
The medical world turned its eyes to CMS on July 29th for the release of its proposed changes to Medicare for 2020. While there are quite a few positive proposed changes, the consensus seems to think there are still areas that could use some work. With the document content looming over 1700 pages, we went through and picked out some of the stand-out topics for your review.