The Senate Finance Health Subcommittee held a hearing on extending access to telehealth services for Medicare beneficiaries. In 2022, Congress extended certain key telehealth flexibilities instituted during the public health emergency (PHE) through December 31, 2024, as part of the Consolidated Appropriations Act, 2023.

• Telehealth emerged as a vital connection for health centers and their patients during and after the COVID-19 pandemic. In 2022, 100% of Pennsylvania health centers offered telehealth services, compared to just 23% in 2019. Virtual visits increased to more than 565,000 in 2022 compared to only 3,400 virtual visits in 2019. Almost half of these virtual visits in 2022 were for behavioral health services at the patients’ discretion.
• Forty-eight percent (48%) of Pennsylvania health centers are in rural communities. Telehealth programs are especially critical in rural areas, where many residents can face long distances and significant commute time between home and health providers, particularly specialized providers. Telehealth remains an integral part of health center operations, even after the end of Public Health Emergency.

Read the testimony from the hearing or watch the live stream here.

This month, Pennsylvania Gov. Shapiro announced a new requirement that all commercial insurers in Pennsylvania provide coverage for autism benefits starting on Jan. 1, 2024, in compliance with mental health parity laws. This follows a notice issued by the Pennsylvania Insurance Department in the PA Bulletin last week. While most commercial carriers operating in Pennsylvania already treat autism as a mental health condition, this action seeks to make that standard universal.

Read the full article here: Shapiro Administration Directs Insurers to Meet Obligations for Autism Coverage Under Mental Health Parity Laws, Removing Barriers to Care and Expanding Access to Services for Pennsylvanians

The Office for Civil Rights (OCR) released two resource documents for providers and for patients to help explain to patients about privacy and security risks to their protected health information (PHI) when using telehealth services and ways to reduce these risks.

On Nov. 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule announcing finalized policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after Jan. 1, 2024. CMS is finalizing conforming regulatory text changes to implement:

• Extending payment for telehealth services furnished in FQHCs/RHCs through Dec. 31, 2024.
• Delaying the in-person requirements under Medicare for mental health visits furnished by FQHCs/RHCs.
• Including marriage and family therapists (MFTs) and mental health counselors (MHCs) as eligible for payment.
• Aligning enrollment policies so that addiction, drug, or alcohol counselors who meet all of the requirements of MHCs to enroll with Medicare as MHCs will also apply for FQHCs/RHCs.
• Medicare coverage and payment for intensive outpatient program (IOP) services furnished by an FQHC/RHC.
• Extension of the definition of direct supervision to permit virtual presence in FQHCs/RHCs through Dec. 31, 2024.
• A change to the required level of supervision for behavioral health services furnished “incident to” a physician or NPP’s services in FQHCs/RHCs to allow general supervision, rather than direct supervision, consistent with the policies finalized under the PFS during last year’s rulemaking for other settings.
• Inclusion of Remote Physiologic Monitoring and Remote Therapeutic Monitoring in the general care management HCPCS code G0511 when these services are furnished by FQHCs/RHCs.
• Inclusion of Community Health Integration (CHI) and Principal Illness Navigation (PIN) services in the general care management HCPCS code G0511 when these services are provided by FQHCs/RHCs. RHCs and FQHCs that furnish CHI and PIN services will be able to bill these services using HCPCS code G0511, either alone or with other payable services on an RHC or FQHC claim, for dates of service on or after Jan. 1, 2024.
• A change in the methodology to calculate the payment rate for the general care management HCPCS code G0511 that takes into account how frequently the various services are utilized.
• A clarification that obtaining beneficiary consent for chronic care management and virtual communications services is required, but the mode of obtaining the consent can vary and direct supervision is not needed.

Review the CMS press release on the PFS, a summary table, Expanded Medicare Reimbursement for FQHCs Starting Jan. 1, 2024, and a one-pager on the new Intensive Outpatient Program benefit.

The Centers for Medicare and Medicaid Services (CMS) was set to implement a deadline requiring Medicare enrollment of home addresses for providers performing telehealth from home. The date for completion of this work was December 31, 2023, but CMS in a November 6 document, Physicians and Other Clinicians: CMS Flexibilities to Fight COVID-19, extended the deadline through December 31, 2024, in response to concerns raised by providers, PACHC, NACHC, and others. Earlier, CMS shared that although this information will be collected for CMS records, the home address does NOT go out on the claims. Between now and the deadline, CMS will work on processes to protect home addresses from public disclosure.

The annual Low-Income Home Energy Assistance Program (LIHEAP) application process for the 2023-24 season is now open for consumers. LIHEAP is a federally-funded program administered by the Pennsylvania Department of Human Services that helps with home heating bills to aid families in staying warm and safe during the winter months. Assistance is available for renters and homeowners. The LIHEAP application period for both cash and crisis grants is open from Nov. 1, 2023, to April 5, 2024. Benefits are determined by county, income, household size and fuel type.

Thanks again to all those who attended the National Stakeholder Call with the CMS Administrator on October 17. In case you missed it, here’s the link to the call summary, recording and transcript: CMS National Stakeholder Calls.

The call featured CMS Administrator Chiquita Brooks-LaSure and her leadership team, who provided updates on CMS’ recent accomplishments and how our cross-cutting initiatives are advancing CMS’ Strategic Plan. CMS serves the public as a trusted partner and steward dedicated to advancing health equity, expanding coverage, and improving health outcomes as we engage the communities we serve throughout the policymaking and implementation process.

We hope you can join us for the next National Stakeholder Call early next year.

November 8th, the Centers for Medicare & Medicaid Services (CMS) began displaying the Birthing-Friendly icon on CMS’s online tool, Care Compare. This new designation identifies hospitals and health systems that participate in a statewide or national perinatal quality improvement program and that implement evidence-based care to improve maternal health. Along with the Care Compare tool, the public can use an interactive map to find the Birthing-Friendly designation at a hospital or health system nearby.  With growing closures of obstetric units in rural hospitals, finding high quality care in rural areas has become increasingly important.

Read the full article here: Biden-Harris Administration Launches ‘Birthing-Friendly’ Designation on Web-Based Care Compare Tool