Fierce Health Payers June 4, 2021
A collection of payer and provider groups is demanding the Biden administration allow Medicare Advantage plans to include audio-only telehealth visits in risk adjustment calculations.
The demand was outlined in a letter to Department of Health and Human Services and Centers for Medicare & Medicaid Services (CMS) leadership released Thursday. The groups were concerned that the inability to incorporate telehealth audio-only visits has impacted payments to plans and negatively hurt vulnerable populations that don’t have access to video capabilities.
Medicare Advantage’s risk adjustment program assigns a risk score to each beneficiary that reflects their overall health costs based on factors such as age and underlying disease. The risk score reflects how much an MA plan gets paid for covering...
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