By Eric Wicklund, mHealth Intelligence | October 4, 2019

President Donald Trump is ordering Medicare to adopt more telehealth programs and pave the way for new technologies, including mHealth tools and services.

In a scheduled visit to a Florida retirement community on Thursday, the President signed an Executive Order that, among other things, aims to give the Centers for Medicare & Medicaid Services more leeway to use connected health services, particularly in Medicare Advantage programs.

Specifically, the order calls on the Secretary of Health and Human Services to, within a year, “propose a regulation to provide beneficiaries with improved access to providers and plans by adjusting network adequacy requirements for MA plans to account for … “the enhanced access to health outcomes made possible through telehealth services or other innovative technologies.”

In addition, the order calls on CMS to “encourage innovation for patients” by “streamlining the approval, coverage, and coding process so that innovative products are brought to market faster, and so that such products, including breakthrough medical devices and advances in telehealth services and similar technologies, are appropriately reimbursed and widely available, consistent with the principles of patient safety, market-based policies, and value for patients.”

Specifically, CMS is being asked to:

  1. Adopt regulations that lessen the time between US Food and Drug Administration approval of new technologies and CMS coverage;
  2. Clarifying how CMS sets coverage for those technologies;
  3. Identifying and addressing challenges associated with parallel FDA and CMS reviews; and
  4. Improving the Value-Based Insurance Design payment model so that it can embrace new technologies that save money and improve quality of care.

The document also makes broad plans to improve Medicare by embracing services that have long been part of the argument for telehealth adoption, including encouraging Medicare to embrace more sites for access to care, removing burdensome licensure requirements, reimbursing primary and specialty care providers for spending time with patients, and improving reimbursements for “non-physician practitioners,” such as nurses and physician assistants.

Delivered at a time when the President is faced with a number of challenges, the order was also draped in political language, with several paragraphs devoted to disparaging the “Medicare for All” concept put forward for Vermont Senator Bernie Sanders, a potential Democratic candidate in the 2020 election.

“Instead of ending the current Medicare program and eliminating health choices for all Americans, my Administration will continue to protect and improve Medicare by building on those aspects of the program that work well, including the market-based approaches in the current system,” the order states. “The MA component, for example, delivers efficient and value-based care through choice and private competition, and has improved aspects of the Medicare program that previously failed seniors.”

The President’s declaration drew praise from the Better Medicare Alliance and Health Innovation Alliance.

“Health Innovation Alliance applauds the administration’s work to further integrate telehealth across the Medicare space,” HIA Senior Director of Government Affairs Catherine Pugh said in a press release. “By leveraging the power of telehealth to fulfill network adequacy requirements in Medicare Advantage and taking new steps to ensure that the Medicare bureaucracy does not slow walk the uptake of new technologies, the administration is poised to expand access to high quality, cost-saving, technology-enabled care for millions. In 2019, no Medicare enrollee’s zip code or specific plan type should hamper their ability to receive 21st-century care.”

“We support efforts to ensure stability for Medicare Advantage, expand value-based care and supplemental benefits, such as telemedicine to improve health outcomes for beneficiaries,” BMA President and CEO Allyson Y. Schwartz said in a separate release.

CMS Administrator Seema Verma also weighed in on the order.

“We look forward to swiftly implementing these bold and comprehensive policies, which build on the steps we have already taken, to increase choices, encourage medical innovation, empower patients, and eliminate waste, fraud and abuse to protect seniors and taxpayers,” she said in a statement.

“President Trump’s Executive Order delivers on the clear promise he’s made to Americans about their healthcare: protect what works in our system and fix what’s broken,” HHS Secretary Alex Azar said in a separate release. “America’s seniors are overwhelmingly satisfied with the care they receive through traditional Medicare and Medicare Advantage, and the President is continuing to take action to strengthen and improve these programs.”

Original Article