FEDERAL TELEHEALTH POLICY Medicare Overall, now that 2023 is over, not much will change federally – for 2024 at least. While the federal COVID-19 Public Health Emergency (PHE) ended last year, the 2023 Consolidated Appropriations Act and the Centers for Medicare and Medicaid Services’ (CMS) 2024 Physician Fee Schedule (PFS) have extended most emergency…
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CMS released improper payment data and corrective actions in the agency Fiscal Year 2023 Financial Report associated with the payment of the Advance Premium Tax Credit, Medicare Fee-for-Service (FFS), Part C (Medicare Advantage), Part D (prescription drugs) and Medicaid/Children’s Health Insurance Program (CHIP) programs. Improper payments can be overpayments or underpayments or payments…
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The federal No Surprises Act (NSA) prohibits out-of-network health care providers and facilities from balance billing commercially insured patients, in certain circumstances. The NSA and its implementing regulations set a method for determining the patient cost-sharing for these out-of-network situations, and when state law does not establish a provider payment methodology, the NSA establishes an…
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For the public health emergency (PHE), CMS altered the definition of “direct supervision” to permit the presence and “immediate availability” of the supervising practitioner through “real-time audio and visual interactive telecommunications.” CMS will continue this policy through December 31, 2024 (it will also be extended to FQHCs and RHCs). (Reference Page, p. 167). Additionally, for…
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Remote Monitoring Services In the Final Rule, CMS provided a clarification on how remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) are addressed and billed. CMS clarified the following points: • After the PHE ends, RPM services are only for established patients. Patients who had received services during the PHE are considered established patients.…
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