Increased Access to Telehealth 

Through a presidential executive order, CMS issued several proposals prioritizing telehealth access:  

• The addition of 135 services covered by CMS if done via telehealth, including emergency department visits, initial inpatient visits, and discharge management  

• Extended payment for other telehealth services such as emergency department visits, through the calendar year in which the COVID-19 coronavirus pandemic ends 

The changes come on the tail of the Rural Telehealth Initiative (https://voice.ons.org/advocacy/fcc-and-usda-partner-for-rural-telehealth-initiative), a response to President Trump’s executive order (https://docs.fcc.gov/public/attachments/DOC-366590A1.pdf) on improving rural health and telehealth access. 

“Telemedicine can never fully replace in-person care, but it can complement and enhance in-person care by furnishing one more powerful clinical tool to increase access and choices for America's seniors,” said CMS Administrator Seema Verma.  

Investment in Preventative Care and Disease Management 

The agency established (https://www.cms.gov/Outreach-and-Education/Outreach/Partnerships/PatientsOverPaperwork) an internal process to evaluate and streamline regulations with goals of:  

• Reducing unnecessary burden 

• Increasing efficiencies 

• Improving the beneficiary experience 

CMS proposed (https://www.cms.gov/newsroom/press-releases/trump-administration-proposes-expand-telehealth-benefits-permanently-medicare-beneficiaries-beyond) revisions to similar services such as maternity care bundles, emergency department visits, end-stage renal disease capitated payment bundles, and physical and occupational therapy evaluation.  

Support for Providers 

CMS also prioritized (https://voice.ons.org/advocacy/surprise-billing-legislation-drug-pricing-reform-stalls-gops-aca-repeal) mitigating surprise billing and coding requirements (https://voice.ons.org/news-and-views/billing-and-coding-breakdown-helps-nurses-recognize-the-realities-of-reimbursement) through the Patients Over Paperwork (https://www.cms.gov/Outreach-and-Education/Outreach/Partnerships/PatientsOverPaperwork) initiative. The agency proposed making permanent the temporary changes that it had made during COVID-19, such as:  

• Nurse practitioners, clinical nurse specialists, physician assistants, and certified nurse midwives can supervise others performing diagnostic tests. 

• Pharmacists can provide professional services of a practitioner who bills Medicare.  

• Physical and occupational therapy assistants can provide maintenance therapy in outpatient settings. 

• Physical or occupational therapists, speech language pathologists, and other clinicians who directly bill Medicare can review and verify information already entered by other members of the clinical team into a patient’s medical record.