News Briefs

✦ As part of the Trump administration’s recent flurry of health care rulemaking, CMS on Dec. 1 issued a final rule updating payment policies under the Physician Fee Schedule, including the permanent expansion of certain telehealth services in Medicare. During a call with reporters, CMS Administrator Seema Verma said nine out of 144 services that were temporarily added during the COVID-19 public health emergency will become a permanent part of the Medicare telehealth benefit, and another 59 services will be extended temporarily after the end of the PHE, allowing CMS to evaluate their impact on quality of care. Verma noted that without congressional action, these changes apply only to rural beneficiaries. Meanwhile, CMS said it is commissioning a study of the telehealth flexibilities it provided during COVID-19 to “explore new opportunities for services where telehealth and virtual care supervision, and remote monitoring can be used to more efficiently bring care to patients and to enhance program integrity, whether they are being treated in the hospital or at home.” View the rule at https://go.cms.gov/3obwdUo.

✦ The Trump administration on Nov. 20 issued two final rules aimed at advancing value-based care and improving care coordination in the private health care and Medicare markets. The CMS final rule, “Modernizing and Clarifying the Physician Self-Referral Regulations,” establishes new exceptions to the Stark Law regulations for value-based arrangements. Meanwhile, a final rule from the HHS Office of Inspector General (OIG) amends the safe harbors to the federal Anti-Kickback Statute by adding new safe harbors and modifying existing safe harbors that protect certain payment practices and business arrangements from AKS sanctions. The rule also codifies an exception to the civil monetary penalty rules to “remove potential barriers to more effective coordination and management of patient care and delivery of value-based care.” Each rule takes effect on Jan. 19, 2021. View the CMS rule at https://bit.ly/2KPqDc0 and the OIG rule at https://bit.ly/3oigSSh.

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Lauren Flynn Kelly

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.

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