Listeners may be aware that up until recently the Medicare program strictly limited provider use of telehealth services via originating site and other numerous other regulatory rules despite its much wider adoption by other payers and the VA. (E.g., see my previous interview/discussion with Ms. Drobac.) Annual Medicare reimbursement for telehealth services equaled approximately 0.003% of annual Medicare spending. With the onset of the COVID-19 pandemic, the Congress and CMS regulators, recognizing the emergency or dire need to maintain a Medicare beneficiary's ability to access to clinical care in a timely manner, markedly expanded telehealth coverage. Both the Congress's March 27th CARES Act and CMS' April 6 interim final rule made sweeping reforms to Medicare telehealth policy.
During this 22 minute conversation Ms. Drobac begins by explaining why the Medicare program significantly restricted use of telehealth. Moreover, she outlines telehealth policy reforms noted in recent COVID-19-related legislation, moreover the CARES Act, and in CMS' interim final rule. She discusses take-up or utilization by the provider community subsequent to these reforms, related Stark law issues, the need or persistence of integrity guard rails, and whether telehealth reforms will persist beyond the COVID-19 public health emergency.
Ms. Krista Drobac is the Executive Director of the Alliance for Connected Care, an organization that advocates for telehealth policy reform. She is also a Partner at the DC-based Sirona Strategies, a health policy consulting firm. Previously, Ms. Drobac was Director of the Health Division at the National Governors Association’s Center for Best Practices. Prior to NGA, Ms.Drobac spent five years on Capitol Hill as a health advisor. Prior still, she was a Senior Advisor at the Center for Medicare & Medicaid Services (CMS) working in Medicaid and private insurance regulation and also served as Deputy Director of the Illinois Department of Healthcare and Family Services. Ms. Drobac holds a BA from the University of Michigan and an MPP from the Harvard University Kennedy School of Government.
The Alliance for Connected Care is at: http://connectwithcare.org/.
Telehealth reform policies detailed in CMS' April 6th interim final rule are at: https://www.govinfo.gov/content/pkg/FR-2020-04-06/pdf/2020-06990.pdf
The CARES Act is at: https://www.congress.gov/bill/116th-congress/senate-bill/3548/text.