Feds OK fix to Medicare billing issues at WV senators' urging

Federal officials have approved a fix to pay discrepancies for health care providers who serve Medicare patients over the phone, according to a news release.

Before the change Thursday, video telehealth appointments for Medicare patients were being billed at a higher rate than audio-only visits.

Had it not been changed, some doctors’ offices in West Virginia, especially in rural areas without access to broadband internet, would have had to close their doors, State Board of Medicine President Dr. Kishore Challa told the Gazette-Mail previously.

Expenses heavily outweigh revenue when providers are forced to bill audio-only telehealth at nearly half the cost of the video telehealth rate, Challa said. Rural patients, often frustrated with video technology, also were continuing to show up to health care offices, putting them at an increased risk for being exposed to COVID-19, she said.

The fix comes less than a day after Sen. Joe Manchin, D-W.Va., and Sen. Shelley Moore Capito, R-W.Va., argued in a letter to Trump administration officials that the pay differences would harm rural providers and put total signed on to the letter.

“I am very pleased that [the federal Department of Health and Human Services] and [Centers for Medicare and Medicaid Services] have made the decision to increase telephone-based telehealth services reimbursements,” Manchin said in a news release. “This change will increase access to health services for West Virginians and ensures that our healthcare professionals are reimbursed fairly for their hard work taking care of their fellow West Virginians throughout this terrible pandemic.”

“During this unprecedented time, it’s important West Virginians and others across the country have access to doctors and other medical professionals in the safest ways possible, which can often be through telehealth,” Capito said in a news release. “We know our state is faced with broadband challenges that we are working to address every day.”

Rural health care centers are moving almost all care for established patients to telehealth, to keep at-risk patients in their homes as much as possible. During the first full week of April, Cabin Creek Health Systems, which operates rural and urban clinics throughout Kanawha County, conducted 807 telemedicine visits over the phone. Just 22 were done by video.

West Virginia’s senators already have worked to relax telehealth requirements. In the early weeks of the coronavirus pandemic, the rule forcing Medicare patients to use only video telehealth for treatment was dropped when the $2 trillion COVID-19 relief package was passed in late March.

While these changes are only in effect during the pandemic period, the ease and effectiveness of telehealth has some providers wondering if they could become permanent.

Sarah Hansen, a nurse practitioner at the Cabin Creek Health Clinic in Dawes, said COVID-19 will likely shift the way health care providers conduct care in the future, especially for rural patients.

“I do think the landscape for how we provide primary care will probably change forever because of this,” Hansen said previously.

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