CMS finalizes plan to allow Medicare Advantage plans to expand telehealth benefits

Medicare Advantage
The Centers for Medicare & Medicaid Services finalized several changes in Medicare Advantage and Part D on Friday. (Getty/designer491)

The Trump administration has finalized several changes in Medicare Advantage (MA) and Part D in anticipation of bid submissions on June 1.

The Centers for Medicare & Medicaid Services (CMS) released a final rule (PDF) Friday that includes technical changes mandated by the 21st Century Cures Act and the 2018 Bipartisan Budget Act, notably targeting telehealth.

CMS will offer MA plans greater flexibility to offer and discount telehealth for specialty care, which will allow them to grow their benefits while meeting network adequacy standards.

“CMS’s rapid changes to telehealth are a godsend to patients and providers and allows people to be treated in the safety of their home,” said CMS Administrator Seema Verma in a statement. “The changes we are making will help make telehealth more widely available in Medicare Advantage and are part of larger efforts to advance telehealth.”

RELATED: CMS may force Part D plans to offer real-time pricing data to members

Earlier this year, CMS finalized a rate increase for MA and Part D of about 4% for the 2021 plan year, up from about 4% the year prior.

In the new rule, the agency also finalized changes to MA and Part D Star Rating methodology to incorporate member feedback to a greater degree. 

"One of the best indicators of a plan’s quality is how its enrollees feel about their coverage experience," CMS said in a release. "This decision reflects CMS’s commitment to put patients first and improves incentives for plans to focus on what patients value and feel is important."

CMS estimates the changes will save the government $3.65 billion.

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