• Drug Coverage
  • Hypertrophic Cardiomyopathy (HCM)
  • Vaccines: 2023 Year in Review
  • Eyecare
  • Urothelial Carcinoma
  • Women's Health
  • Hemophilia
  • Heart Failure
  • Vaccines
  • Neonatal Care
  • Type II Inflammation
  • Substance Use Disorder
  • Gene Therapy
  • Lung Cancer
  • Spinal Muscular Atrophy
  • HIV
  • Post-Acute Care
  • Liver Disease
  • Pulmonary Arterial Hypertension
  • Safety & Recalls
  • Biologics
  • Asthma
  • Atrial Fibrillation
  • Type I Diabetes
  • RSV
  • COVID-19
  • Cardiovascular Diseases
  • Breast Cancer
  • Prescription Digital Therapeutics
  • Reproductive Health
  • The Improving Patient Access Podcast
  • Blood Cancer
  • Ulcerative Colitis
  • Respiratory Conditions
  • Multiple Sclerosis
  • Digital Health
  • Population Health
  • Sleep Disorders
  • Biosimilars
  • Plaque Psoriasis
  • Leukemia and Lymphoma
  • Oncology
  • Pediatrics
  • Urology
  • Obstetrics-Gynecology & Women's Health
  • Opioids
  • Solid Tumors
  • Autoimmune Diseases
  • Dermatology
  • Diabetes
  • Mental Health

2021 Medicare Advantage Rule Another Booster on Rocketing Telehealth


The meteoric rise of telehealth amid the COVID-19 outbreak was recognized and possibly given an added boost by the rule for the 2021 Medicare Advantage contract year issued by CMS today.

The new rule allows MA plans to count telehealth providers in a wide range of specialties toward their network adequacy standards, CMS said in press statement summarizing the new rule. Dermatology, psychiatry, cardiology, ophthalmology, nephrology, primary care, gynecology, endocrinology, and infectious diseases were listed in the release.

As indicated before today, the new rule also opens up MA enrollment to more people end-stage renal diseases. Another change is added weight to patient experience and access metrics in the Star rating system that is a factor in how much the federal government pays MA plans.

Roughly, 34 million Medicare beneficiaries, or about a third of the total, are now enrolled in MA plans, a proportion that has grown steadily since the early 2000s. 

Better Medicare Alliance (BMA), a group that lobbies for the program, was enthusiastic about the 2021 rule in a press release, saying that it applauded provisions dealing with telehealth, network adequacy and supplemental benefits for the chronically ill.

“This final rule takes important strides to preserve and strengthen the Medicare Advantage coverage that 24.4 million beneficiaries rely on today,” Allyson Y. Schwartz, the group’s president and CEO, said in the press release.

You can read a CMS factsheet about the new rule here and download the rule from the Federal Register here.

CMS said in the prepared statement that because of the impending June 1, 2020, MA and Part D bid deadlines for the 2021 plan year, it was  finalizing a subset of proposed policies before the due date and that it will address the remaining proposals for plans later in 2020 for the 2022 plan year.

“We understand that the entire healthcare sector is focused on caring for patients and providing coverage related to coronavirus disease 2019 (COVID-19), and we believe this approach provides plans with adequate time and information to design the best coverage for Medicare beneficiaries,” said the CMS statement.

Related Videos
Video 3 - "In-Office Procedures, Over-the-Counter Options, Treatment Delays, and Costs"
Video 6 - "Safety Analysis and Interpreting Results from MAJIC-PV"
Video 5 - "Key Findings from MAJIC-PV"
Video 2 - "Traditional Treatment of Demodex Blepharitis, FDA approval, and Lotilaner Ophthalmic Solution, 0.25%"
Gabriela Hobbs, MD, an expert on polycythemia vera
Gabriela Hobbs, MD, and Timothy Mok, PharmD, BCPS, BCOP
Video 1 - "Demodex Blepharitis: Prevalence, Symptoms, Quality of Life Impact, and Diagnosis"
Video 2 - "The Role of Ruxolitinib in Managing Hydroxyurea Resistance or Intolerance"
Video 1 - "Prevalence and Impact of Hydroxyurea Intolerance or Resistance in Polycythemia Vera"
Related Content
© 2024 MJH Life Sciences

All rights reserved.