Page 36 - Telemedicine - Essentials of Virtual Care Delivery Part Two

SVMIC Telemedicine: Essentials of Virtual Care Delivery

Medicare Advantage, APMs and ACOs

Medicare offers some exceptions to its geographic and
originating site requirements through special programs,

including the Next Generation ACO, Shared Savings Program,
Episode Payment Models, and Comprehensive Care for Joint

Replacement Models. Factsheets are available on many of these
models under CCHP’s Resources tab. Medicare Advantage

Plans may also offer telehealth as a supplemental benefit;
however, patients who elect to receive the benefit may pay for it

with higher premiums, additional co-pays, or from plan rebates.

MIPS

Telemedicine is one of the options available for meeting the
clinical improvement activity requirement in the CMS Merit-

based Incentive Payment System (MIPS).

Parity Laws for Commercial Insurers

According to a November 2016 NBC Nightly News report,
12
over 30 states had adopted some form of telemedicine payment
parity law. These require commercial insurers to cover certain

telemedicine visits that are comparable to the level of service as
an office visit.

12 NBC Nightly News, Growing U.S. Telemedicine Market Raises Questions About Cost (Nov.
24, 2016), https://www.nbcnews.com/nightly-news/video/growing-u-s-telemedicine-market-
raises-questions-about-cost-817215043553.

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