Wein, Ferrante Comment on Telehealth Changes For Medicare Advantage Providers
27 April 2020
Of Counsel Emily Wein and Senior Counsel Thomas Ferrante were quoted in a Part B News article, “CMS lets MA providers do telehealth risk adjustment; tight documentation advised,” about a change in CMS policy allowing Medicare Advantage providers to do risk adjustment by telehealth during the coronavirus pandemic.
Wein said guidance on telehealth from Medicare administrative contractors (MAC) is helpful, but suggests that MA providers new to telehealth go a step further and walk through their reasoning in notes. “Maybe in the initial stages, providers should take extra efforts to show professional judgment was exercised in using telehealth, not just assert ‘the MAC said I could,’” she said.
Ferrante said providers should not offer a provisional diagnosis for risk adjustment purposes contingent on the patient coming in when the current emergency is lifted. “I don’t know if the subsequent visit would be reimbursable,” he said. “If you think the provider had enough under the current emergency guidance, what would be the justification for bringing the patient in again?”
(Subscription required.)
Wein said guidance on telehealth from Medicare administrative contractors (MAC) is helpful, but suggests that MA providers new to telehealth go a step further and walk through their reasoning in notes. “Maybe in the initial stages, providers should take extra efforts to show professional judgment was exercised in using telehealth, not just assert ‘the MAC said I could,’” she said.
Ferrante said providers should not offer a provisional diagnosis for risk adjustment purposes contingent on the patient coming in when the current emergency is lifted. “I don’t know if the subsequent visit would be reimbursable,” he said. “If you think the provider had enough under the current emergency guidance, what would be the justification for bringing the patient in again?”
(Subscription required.)
People
Related News
24 April 2024
In the News
Judith Waltz Discusses Nursing Home Staffing Mandate, Potential Legal Challenges
Foley & Lardner LLP partner Judith Waltz offers insight on a new nursing home staffing rule from the U.S. Department of Health and Human Services and its impact on the industry in the Bloomberg Law article, “Nursing Homes, HHS on Collision Path Over Staffing Mandate.”
23 April 2024
In the News
David Sanders Discusses Lessons Learned from General Counsel Leadership Program
Foley & Lardner LLP partner David Sanders recently joined a panel discussion with members of The Vanguard Network’s General Counsels Advisory Group to discuss the evolving role of the general counsel.
23 April 2024
In the News
Claire Marblestone Discusses HHS Final Rule on Protected Health Information Disclosure
Foley & Lardner LLP Claire Marblestone assessed the U.S. Department of Health and Human Services’ final rule that bars providers, health plans, and other entities covered by the Health Insurance Portability and Accountability Act from disclosing protected health information in a Healthcare Dive article.