RISE reviews the latest headlines that have an impact on Medicare and Medicare Advantage.
MedPAC recommends telehealth flexibilities continue after end of public health emergency
The Medicare Payment Advisory Committee (MedPAC) this week released its March 2021 Report to the Congress: Medicare Payment Policy and offered recommendations for continuing Medicare’s coverage of telehealth services in a post-COVID landscape.
The report suggests telehealth flexibilities continue for one or two years after the emergency is lifted to gather evidence about the impact of telehealth on care access, quality, and program spending. Without legislative action, many of the changes will expire at the end of the public health emergency.
During that limited time, MedPAC said that Medicare should temporarily pay for specified telehealth services regardless of a provider’s location, and the Centers for Medicare & Medicaid Services (CMS) should continue to pay for newly covered telehealth services and some audio-only telehealth care. Furthermore, MedPAC recommends that after the public health emergency ends, Medicare should return to paying the physician fee schedule’s facility rate for telehealth services and collect data on the cost of providing those services. Providers should also not be allowed to reduce or waive beneficiary cost sharing for telehealth services after the emergency. CMS should also implement other safeguards to protect Medicare program and its beneficiaries from unnecessary spending and potential fraud related to telehealth, according to MedPAC.
Biden may extend ACA special enrollment period
Bloomberg reports that the White House may extend the 2021 Marketplace Special Enrollment Period for Affordable Care Act health plans beyond its expiration date of May 15. More than 206,000 Americans signed up for the health insurance plans during the first two weeks of the special enrollment period, which was opened to all Americans in response to the COVID-19 public health emergency. An administration official, who asked to remain anonymous, told Bloomberg that a decision about the deadline extension won’t be made until closer to May 15.
Report: Senate likely to confirm Becerra as HHS secretary on Thursday
Despite fierce opposition from Republicans, the Senate is set to confirm Xavier Becerra as secretary of the Department of Health and Human Services, according to ABC News. If confirmed, Becerra, who currently serves as the attorney general of California and has led the defense of the Affordable Care Act in the Supreme Court, will be the first Latino to lead the department. Republican senators oppose his nomination, claiming he doesn’t have enough experience in health care to lead the agency.
CMS ups payment for administrating COVID-19 vaccine
The Centers for Medicare & Medicaid Services (CMS) announced this week it will increase the Medicare payment amount for administering the COVID-19 vaccine. Beginning March 15, the national average payment rate for physicians, hospitals, pharmacies, and many other immunizers will be $40 to administer each dose of a COVID-19 vaccine. This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines and an increase from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished. For calendar years 2020 and 2021, Medicare will pay providers directly for the COVID-19 vaccine (if they do not receive it for free) and its administration for beneficiaries enrolled in MA plans. CMS clarified that MA plans are not responsible for paying providers to administer the vaccine to MA enrollees during this time. Like beneficiaries in original Medicare, MA enrollees also pay no cost-sharing for COVID-19 vaccines.
HHS to invest billions to address disparities and advance equity in COVID-19 testing and mitigation
The U.S. Department of Health and Human Services (HHS) said Wednesday it would invest $2.25 billion from the American Rescue Plan to scale up testing in underserved populations. The funds to address COVID-19 health disparities and advance health equity among high-risk and underserved populations will include racial and ethnic minority groups and people living in rural areas. The funding represents the Centers for Disease Control and Prevention’s largest investment to date to support communities affected by COVID-19-related health disparities. Grants to public health departments will improve testing and contact tracing capabilities; develop innovative mitigation and prevention resources and services; and improve data collection and reporting to advance health equity and address social determinants of health as they relate to COVID-19.