Posted in Policy

CMS proposed rule aims to boost telehealth

Chris Nerney
Chris Nerney, Contributing Writer |
CMS proposed rule aims to boost telehealth

The Centers for Medicare and Medicaid Services (CMS) on Thursday proposed a new rule that Administrator Seema Verma called one of “the most significant reductions in provider burden undertaken by any administration.”
The proposed 2019 update to the Physician Fee Schedule and Qualified Payment Program is designed to reduce the paperwork burden physicians face when billing Medicare, while also increasing interoperability and patient access to telehealth.
"Today is a huge win for patients and providers as CMS is proposing historic changes to modernize Medicare and restore the doctor-patient relationship," Verma said in a conference call with reporters, as Healthcare IT News reports.
Specifically, the proposal would simplify, streamline and offer flexibility in documentation requirements for evaluation and management office visits, which CMS says comprise about 20 percent of allowed charges under the Physician Fee Schedule and “consume much of clinicians’ time.”
It also would reduce physician supervision of radiologist assistants for diagnostic tests and remove functional status reporting requirements for outpatient therapy, which CMS calls “burdensome and overly complex.”
Provisions in the proposed CY 2019 Physician Fee Schedule would support access to telehealth care by:

  • Paying clinicians for virtual check-ins (brief virtual appointments via video or audio communications)
  • Paying clinicians for evaluation of patient-submitted photos
  • Expanding Medicare-covered telehealth services to include prolonged preventive services

“We’re not intending to replace office visits but rather to augment them and provide new access points for patients,” Verma said to reporters. "There are going to be many situations where a physician might say 'I’m going to need to see you in my office' but it could be a check-in where they come in for a visit and they want to talk to their doctor about the medication that they’re taking and how it’s impacting them, and [this gives] the ability for them to not have to come in physically to have that conversation with the doctor, but to be able to have that remotely."
Being able to use telehealth services can be a big help to Medicare patients who lack a car, a ride, or live far from their healthcare providers.
“Many times this type of check-in will resolve patient concerns in a convenient manner that gets them the care that they need and avoids unnecessary cost to the system,” Verma said. “This is a big issue for our elderly and disabled populations where transportation can be a burden to care as well as to caregivers.”
CMS said the proposed changes to the Quality Payment Program (QPP) would reduce clinician burden, focus on outcomes, and promote interoperability of electronic health records (EHRs) by:

  • Removing QPP’s Merit-based Incentive Payment System’s (MIPS)  process-based quality measures that CMS said clinicians complain are low-value or low-priority, emphasizing instead “meaningful measures that have a greater impact on health outcomes”
  • Overhauling the MIPS “Promoting Interoperability” performance category to support greater EHR interoperability and patient access to their health information, as well as to align this performance category for clinicians with the proposed new Promoting Interoperability Program for hospitals

You can read more details of the CMS proposed rule here.