The Centers for Medicare & Medicaid Services (CMS) proposed the Home Health Prospective Payment System Rule in June to increase Medicare payment rates for home health agencies. Within the Rule, CMS has asked for the COVID-19 public health emergency provisions for telehealth to be made permanent. CMS telehealth guidance and the proposed Rule are discussed below.

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CMS Telehealth and COVID-19

Before the pandemic, access to telehealth was limited, especially for Medicare patients. Previous to the emergency telehealth protocols released during the COVID-19 pandemic, CMS reimbursement for telehealth patients was based on the patient’s geographical location, limiting reimbursement for telehealth to patients based on where they live. 

The emergency telehealth rules have temporarily eased restrictions, enabling increased access to telehealth for patients that, under normal circumstances, were not eligible to receive care virtually. 

Home Health Prospective Payment System Rule: CMS Telehealth Guidance

One of the major components of the proposed Rule is asking for a permanent change to be made for CMS telehealth. The proposed changes are set to be in effect for January 2021, and particularly apply to the loosened restrictions surrounding telehealth for remote patient monitoring. 

CMS hopes that with the issuing of the new Rule, more home health agencies will be incentivized to support remote care, even with the current lack of telehealth reimbursement. Making telehealth access permanent, beyond the COVID-19 crisis, will drastically improve patient access to healthcare.

Additionally, the CMS telehealth guidance would provide patients better access to the latest technology to ensure that patients are receiving the best care possible. Access to telehealth under current regulations is severely limited for home health agencies. Once the public health emergency expires at the end of July 2020, telehealth will be unable to be used as an alternative to in-person visits. 

This is particularly concerning for vulnerable patients, as well as patients living in areas in which access to healthcare is limited.

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