On November 1, CMS revealed updates to the 2019 Physician Fee Schedule and the Quality Payment Program.
One of the changes involved virtual care.
For the first time, Medicare will pay providers for communication technology-based services like brief check-ins between patients and clinicians. It will also pay separately for the remote evaluation of recorded video and/or images submitted by an established patient. CMS is also expanding the number of Medicare-covered telemedicine services.
There’s been plenty of hype around the final rule and what it will do for telemedicine. But if we take a closer look, what are its implications on healthcare and the future of the industry?
In a recent phone interview, Matt Fisher, a partner with Mirick O’Connell and chair of the firm’s Health Law Group, said the changes are positive on the whole. Expanding telehealth reimbursement coverage is typically beneficial.
“Obviously I suspect it doesn’t go as far as full telemedicine advocates would like to see,” he added. “Hopefully it continues to lay the groundwork for more changes.”
Within the bigger picture, Fisher said the news shows the incremental progress that’s happening within the space.
“I think inclusion for payment means we’ve moved beyond the phase of questioning whether these telemedicine services are viable,” he said. “Now it’s just figuring out to what scope they’re going to be provided.”
Additionally, private payers often make moves based on what Medicare does, he noted. Thus, the latest change could provide room for private payers to rethink reimbursement when it comes to telehealth.
Despite the pros, some remain wary about the final rule. A Kaiser Health News article from early October pointed out that many physicians believe the reimbursement (getting paid $14 for a “check-in” with their patients) will simply cover a service they already do for free.
Fisher also noted that perhaps this virtual check-in piece is being overblown. After all, many doctors have already been following up with their patients over the years regardless of reimbursement.
He had one final word of caution: “As you’re going about implementing these tools, you can never forget about the privacy and security side of things.”
Ultimately, it’s not worth it to rush into utilizing tech without ensuring HIPAA compliance.
Photo: chombosan, Getty Images
