POSTED ON MONDAY, June 1, 2020
Congress made it clear through the CARES Act that the CMS should do everything in its power to promote the use of telehealth tools during the COVID-19 outbreak. Many home health advocates expected the legislation would lead to direct reimbursement for virtual visits, but it did not.
“I was surprised the CARES Act failed to provide a pathway for home health providers to get paid for providing remote care,” Rebecca Gwilt, co-founder of Nixon Law Group, told Home Health Care News. “[In turn], CMS encouraged the use of telehealth for home health patients but did not change the policy that only counts in-person visits for the purpose of paying full reimbursement for an episode of care.”
“Because Congress and CMS haven’t created a mechanism for telehealth reimbursement, home health providers are effectively penalized for using such tools to supplement in-person visits, according to Gwilt, whose firm works with a variety of health care providers, life sciences entities and medical technology companies. Essentially, that “penalty” comes in the form of paying for costly telehealth systems and visits without financial support from government payers while, at the same time, being exposed to low-utilization payment adjustments (LUPAs).”
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